Patrick McFadden: Of the 2 million pensioners whom the Secretary of State mentioned, 5,600 in my constituency are receiving pension credit at an average rate of £45 a week, which makes a huge difference to their standard of living. Will he assure the House that, whatever the Government's response is to the Turner commission report, we will not return to the days before the pension credit, we will keep protecting the incomes of the poorest pensioners, and we will not see again the situation when the Conservatives were in power in which pensioners were expected to live on as little as £69 a week.

Roger Gale: The Minister knows perfectly well that there is not a Member of the House who has not got a file of letters from parents with children who cannot access the money to which they are entitled, and an equivalent file of letters from absent parents who cannot afford the demands that are made on them. While both those sequence of cases are causing misery, the information technology is failing and the people working it are failing. Has not the time come to draw this whole sorry episode to a close and replace it with something that works?

Mark Francois: It does, Mr. Speaker, but might I humbly add that this is an important matter, because the current class of carriers are growing old and will be withdrawn, and the sea harriers that they carry for the air defence of the fleet are being withdrawn now, so the fleet is without long-range air defence? I realise that you are not responsible for the actions of the Prime Minister, but is there anything further that you can do for the security of the Royal Navy?

Ruth Kelly: I do not. The hon. Gentleman is right to say that the duty refers specifically to working families but, as child care provision is increased, that child care provision will also be there for those families where no one is in work. As the supply increases, it will not differentiate between the types of parent who wants to avail themselves of child care.
	These measures call for an appropriate regulation and inspection framework both to give parents confidence that their child is safe and secure and to give children high quality learning experiences and stimulation. For young children, there is no distinction between care and learning. Care cannot be considered good quality unless it provides opportunities for children to learn. Equally, learning must be provided in an environment where children feel safe and secure. However, the current system implies that there is a difference between care and learning. That is why we want to change the legal structure to bring them together in a single coherent system that allows young children to be safe and secure and to learn and develop through purposeful play, just as they would at home with their parents.
	To achieve that, the Bill will introduce the early years foundation stage—a single phase of development for all young children during which activities appropriate to their age will be provided to support development. That will build on the widely welcomed foundation stage and the "Birth to Three Matters" framework, and help us to ensure that all children are getting a good start in life. Our objective is for all providers to work to and be inspected against the same framework. That will reduce bureaucracy and raise the bar on quality.
	Currently, all child care providers for children under the age of eight must register with Ofsted. However, there is no such requirement on those that provide only for children over the age of seven, so parents have no way of knowing that that provision is safe and that their children will be looked after well. The Bill will simplify and extend the current regulatory framework so that for the first time Ofsted registered child care will be available for children over seven. Registration will be voluntary for providers that care only for children aged eight or above. We think that that is right and proportionate to the level of risk.
	However, there will be strong levers to register for all those providing child care. For example, only registered provision will be eligible for tax credit support. We will also provide guidance to schools developing extended services that they should work only with registered providers. The inspection regime for child care provision at schools will also be simplified. If a school provides child care for its pupils on the school site, it will be inspected by Ofsted as part of the routine school inspection.
	This landmark Bill shows a Government who assess and act, listen and respond, and learn and move forward. We have witnessed fundamental changes in the world of work and in the way in which families want to live their lives and we have taken decisive steps. As a result of the Bill, parents will have the certainty of knowing that, whatever their situation, high quality early years services and child care will be available to support them and their children.
	The Bill is an essential part of our drive to ensure that every child has the chance and support that they need to fulfil their potential. It is an essential part of a modern Government, forging a modern welfare state that supports families and helps them in making difficult decisions on balancing work and family life. That is what this Government believe in and what the Bill is all about. I commend it to the House.

Theresa May: My hon. Friend is right that, contrary to the claims made by the Secretary of State about child poverty, the gap has got wider under this Government, rather than improving.
	We recognise that affordable quality child care is one of the most important concerns for many hard-pressed working families today. Indeed, for some families, access to any child care is a problem. Quality child care and effective parental support are critical to ensuring that children reach their true potential, and that families are able to make the choices about their work-life balance that best suit them, although I recognise that, for many families, it is simply a question of being able to meet the increasing demands of paying their mortgage, tax and other household bills. For the sake of the children, we must get this right, and that is why we want to do our best to ensure that the Bill goes as far as possible towards helping children. However important the issues the of work-life balance might be, the outcomes for children are what really matter.
	We have a number of concerns about the Bill, and I shall outline them later. The Secretary of State mentioned the Work and Families Bill, which will come to the House in a week's time. It will deal with work-life balance and parental leave, and this Bill deals with child care provision for those who are working. I am surprised that we are dealing with these issues in two separate Bills. Surely it would have made more sense for the Government to address them all together in one Bill, to ensure that we came up with joined-up legislation that works for children and families. I cannot help feeling that the presence of two Bills on these matters, led by two different Departments, reflects the fact that the Government have singularly failed to deliver the joined-up government that they promised.
	The challenge for the Government—and for us, working to be back in government—is to so manage the operations and working of government that it works for people and not for Ministers and civil servants. Alternatively, perhaps the chance to issue two press releases and to make two headlines carried more weight among the Government's spin doctors than the needs of families.

Ruth Kelly: Are you going to support it?

John Bercow: My hon. Friend has identified one example in which what the Government said does not appear to match that for which the Bill provides. It is clear from clauses 12 and 13 that there will be an obligation to provide advice and assistance to parents and, in certain circumstances, to provide training to child care providers. Given that none of those is currently a duty under statute, it logically follows that all are new. Why is it that the Secretary of State is right and the head of the early years development partnership in Buckinghamshire is somehow wrong?

Paul Goodman: My hon. Friend the Member for Buckingham (Mr. Bercow) referred to clauses 12 and 13, but clause 11 states:
	"An English local authority must prepare assessments of the sufficiency of the provision of child care".
	That too will surely bring costs in its wake. Should not my hon. Friend add that to her list of costs?

Joan Humble: I was going to put that question to the Minister, and I hope that she will respond to both the hon. Gentleman and me at the end of the debate. In fact, I want to list four key aspects of the Bill: first, the emphasis on improving outcomes; secondly, the role and responsibilities of local authorities; thirdly, parental involvement; and, fourthly, the new quality and regulatory framework.
	First, I want the Bill to improve outcomes, especially for two key groups: first, low-income families and, secondly, families with disabled children. The Bill rightly focuses on working parents because it is important that they have access to the best possible quality of child care.
	We must not forget about workless parents. Some parents who stay at home with their children are not disadvantaged—it is their freely-made choice. However, other workless parents find themselves at home because they have mental health problems, for example. They may be a long way from engaging in the labour market and might not have the confidence to look for training and educational opportunities.
	As the Minister takes the Bill forward, will she ensure that such disadvantaged workless families are taken into account? The Bill sets out local authorities' responsibilities as the providers of support for children through the child care services in general. I hope that the Minister will consider the overall role of local authorities and ensure that such workless parents are helped by, and benefit from, the increase in child care that will result from the Bill.
	That exact group has been helped by the Sure Start project. I have talked to parents who lacked confidence before they got involved with Sure Start and were frightened to access the support provided by statutory agencies. All too often, those parents' experience of education was not happy, so seeking education and training in colleges was a difficult step for them. However, through Sure Start, their self-confidence increased. Talking to other parents and educational and health care professionals encouraged them to realise that they could cross the threshold of a further education college and develop their potential. That was the one single success of Sure Start for many of them. Sure Start has addressed the needs of parents as much as the needs of children, so I hope that the Minister will recognise that in her analysis of the scheme. I acknowledge that it will be more difficult to measure outcomes for such workless parents than for working parents. However, I am sure that my right hon. Friend the Minister will address that matter.
	In the UK, there are 770,000 children with a disability or a limiting long-standing illness. The number of children with complex needs is growing all the time. Some 55 per cent. of disabled children's families live in poverty. The families of severely disabled children face three times the costs of other families, yet only 16 per cent. of disabled children's mothers work, compared with 66 per cent. of other mothers.
	Last year, Contact a Family conducted a survey that found that a third of such parents were paying more than £5 an hour for child care and that 6 per cent. were paying more than £20 an hour. That was happening at a time when the average cost of a nursery place was £2.80 an hour, so the families of children with disabilities are facing real costs. If the Bill is genuinely to improve outcomes for disabled children, it must address the cost pressures on their families.
	Interestingly, at the last meeting of the all-party childcare group, we heard heartrending accounts from such parents about their difficulties in accessing child care. They experienced several problems, such as a lack of information. Many mainstream nurseries would not accept their children, whether that was because of access problems or for reasons of staff training. All too often, the parents found that staff lacked the confidence to deal with children with disabilities. I hope that my right hon. Friend pays special attention to training that gives confidence to staff who work in a variety of child care settings so that they are enabled to accept willingly a child into their care. Many parents tell me that even in nurseries that can be accessed by disabled children because they have adapted equipment, the attitude of the staff is disabling. It reflects the old adage that the child is not disabled; it is society that is disabled in its response to the child. We must not have that and need to consider the problem as we develop child care provision.
	The many workless families with disabled children welcome child care not just because some of the parents want to go out to work—polls and analysis of parents' wishes show that many of them want to work—but because they want their children to socialise. It also allows them respite. We must take those considerations into account. When my right hon. Friend the Minister consults on the birth-to-five framework, I urge her to consider an explicit recognition of the needs of children with disability.
	Transport has been raised with me. When families with children with disability send their child to a day care setting or a school, they have transport problems because it comes at a certain time and picks a child up at a certain time. If we want to use the extended school model to include families with disabled children, we have to consider transport arrangements. It will not be easy in some areas. For example, it will be harder to arrange taxis and other forms of transport to ferry disabled children back and forth in shire counties with large rural areas. Nevertheless, we should send out the message to disabled children that they too can access the earliest provision and the wrap-around care—the extended school hours—that is being developed.
	We must also consider the needs of the whole family. Families with disabled children—some have more than one—often have other children as well. Local authorities should take other siblings into account when they think about the needs in their area. When they liaise with other statutory agencies, as the Bill requires them to do, will that include health authorities and primary care trusts? A key problem for families with children with disability is that their children are sick more often than other children. If parents choose to go to work, they are more likely to be phoned up by the nursery and told, "Your child is ill. Please come and take her home."
	Again, there are no easy answers to that, but if we are to encourage parents of disabled children to access the work force, we need to consider how pre-school provision responds to sick children. In addition, many children with disability are incontinent well into their teens. Again, how will child care respond to that? I hope that my right hon. Friend ensures that there is liaison not just with the Department of Health, but with the Department for Work and Pensions, because such issues need to be taken up with it as well. Parents of profoundly disabled children want a clear message that they are included in the provisions of this excellent Bill. I call on her to say that.
	Secondly, I want to refer to the role of the local authority and to some of the phrases in the Bill. What do phrases such as,
	"so far as is reasonably practicable"
	and "sufficient childcare" mean? Referring back to my point about children with disabilities, there are practical issues that local authorities will have to face. There will be issues for parents, especially those with profoundly handicapped children. Such parents will need clarification, as will local authorities about their role. I emphasise that, although the Bill refers specifically to the employment status of parents, I hope that we can look beyond that.
	Many local authorities are as keen as parents to ensure high-quality child care, and that brings me to the issue of resources. I hear what my right hon. Friend the Secretary of State says about the big increase in local authority resources over the next couple of years, especially to improve the number of child care places, but she will be aware of pressures on the budgets of many local authority child care services. Given the pressures on Blackpool council and the important work that it does in protecting children from harm, there are many calls on its budget.

Joan Humble: Everybody present is taking part in this debate because we all care about these children and their needs. There are issues about the availability of child care places in some areas, especially in relation to child protection. However, I can see the opportunities presented by the Bill and by other legislation. There will be opportunities through the development of children's trusts to integrate services much more coherently, which I hope will help the development of exactly that sort of cross-working. Sometimes, when social services departments intervene to protect children, the families involved are exactly those for whom the local authority wants to provide child care support. So, there needs to be working across local authority departments. I see the framework of children's trusts as an opportunity to do that as well as to involve other agencies, such as the health service, which are vital.
	However, will my right hon. Friend monitor what resources are available? I repeat that I recognise how much money is being put in, especially to develop children's centres. That is very welcome. I visited Kincraig primary school in Blackpool last Friday, where I talked to people who are very much looking forward to having a children's centre.
	The third area that I identified was parental involvement. It will be vital to the success of the Bill to involve parents in the development of provision. In spite of the information that is available, parents still come to me because they do not know what services they can access. The requirement on local authorities to seek out parents to tell them what services are available is welcome, but it is equally important that those parents are part of the development of services. For example, parents of children with disabilities should be included in considering how services can be improved and developed. Parents from black and minority ethnic groups should be involved. We must ensure that services are culturally appropriate and that such parents do not feel excluded. Parents in Fleetwood were involved in the development of the Sure Start project from the outset. Before a suitable building was identified and opened, the local managers talked to them about the services that they wanted. As a result, parents feel ownership of those services—they welcome them and engage with the delivery of direct child care provision and all the other support that is offered to them.
	Finally, I welcome the new quality and regulatory framework. My reading of clause 41 is that developmental requirements are on a par with learning requirements. However, that is a false dichotomy. The Bill creates a welcome single framework for early years education and child care instead of dealing with education on the one hand and social care and health development on the other. The two are inextricably linked—children learn through play and by observing others. Children are now examined for their developmental progress. Health visitors used to visit me to make sure that my children had reached developmental milestones as babies, so such provision is not new. As the framework is developed, however, it is important that parents understand it. Sadly, parents who read the headlines in the media may think that their six-month-old will be propped up, a book placed in front of them and a pen put in their hand. [Interruption.] I admit that I read to my children when they were little, because it is good practice to teach children from a young age to follow the reading movement from left to right so that when they learn to read they can follow sentences from left to right and identify pictures. I remember teaching my children colours and shapes and playing with them as part of the educational process. We should reassure parents that the foundation stage—the new framework—encourages them to do all that with their children. We should explain that if they place their child in a child care setting, whether with a child minder or in a nursery and so on, the trained staff will do the same.

Annette Brooke: It is a pleasure to follow the hon. Member for Blackpool, North and Fleetwood (Mrs. Humble), whose constituency title is almost as complicated as mine. She has brought great experience and knowledge to the debate.
	On behalf of the Liberal Democrats, I welcome the Bill. Given that much of our long-term policy work and commitment relating to early years provision is compatible with the 10-year child care strategy, it would be churlish not to express that general support. However, that does not mean that the Bill has our wholehearted support in its present form. There are a number of issues that I shall raise, and a great deal of detail will have to be addressed in Committee.
	Like the Secretary of State, I believe it is worth reflecting on what has been achieved since 1997. I was a chair of education pre and post-1997, and I would be the first to acknowledge the extremely low base from which the Government started and the enormous progress that has been made from 1997 onwards. The creation of early years development and child care partnerships in local authorities, a free nursery education place for all three and four-year-olds whose parents want one, Sure Start, early excellence centres, neighbourhood nurseries and so on, and now children's centres are to be extended to an additional 300,000 pre-school children across 136 local authorities, plus the extended school programme. However, issues have inevitably arisen, and given the sums of money being invested, it is right that clear evaluation and monitoring take place.
	I understand that in 2004–05, total public spending on child care was around £5 billion, and I agree with the right hon. Member for Maidenhead (Mrs. May) that we need value for money from such sums. The National Audit Office reported in 2004:
	"From the launch of the measures announced in the National Childcare Strategy to spring 2003, 626,000 new childcare places for all ages were created in England. However, 301,000 places have closed"—
	for every two places created, one was closed. Sustainability has been an issue and will continue to be one, and needs to be monitored.
	Earlier this year I recall the same confusion as the right hon. Member for Maidenhead surrounding the outcomes of Sure Start. I appreciate that evaluation is continuous at a local and national level, and given the wide local variations in schemes and the length of time that it would take nationally to get a true picture, it is important not to jump to hasty conclusions, but feedback is needed. I join the right hon. Lady in calling for some indication of when an evaluation will be published. I note that the national evaluation runs from 2001 to 2008, and is predicted to cost more than £20 million.
	Issues have arisen relating to the quality of provision throughout the period that I referred to—for example, the "Panorama" programme which showed some worrying tendencies in terms of quality in some settings. Will the roll-out programme of children's centres, with the provision and level of non-ring-fenced resources to local authorities, mean a watering-down of the original concept and practice of Sure Start?
	In 2004, according to the Social Market Foundation report on life chances and early years, 26 per cent. of families reported unmet demand for child care, with lone parents, parents in deprived areas and parents of children with special needs affected most severely. Those conclusions seem to underpin the need for the type of proposals that we are discussing, especially as I assume that 26 per cent. must be an understatement of what the demand would have been if parents had access to more information on availability, affordability and so on.
	Further underpinning for the Bill's strategy comes from the EPPE—effective provision of pre-school education—project, published last year, which found that pre-school children with three years' quality pre-school provision who started in nursery at two or younger were up to a year ahead of their contemporaries in educational attainment when they started school. Notwithstanding that report, it is important to consider other evidence that might lead to different conclusions.

Annette Brooke: There are strengths and weaknesses in diversity and in some ways much was learned by having different types of project. I shall talk later about quality assurance in the context of the Bill, which will be more relevant.
	A number of US studies have concluded that maternal employment, particularly full-time, during the first year of a child's life is associated with poorer outcomes. On the other hand, UK evidence—in a study this year—found that only full-time, not part-time, work during the first 18 months of a child's life might have adverse consequences, but that they were minor. There were variations depending on income and education. The study also found that the quality of non-parental care is highly significant in determining outcomes. Other studies suggest that antisocial behaviour in children may stem from some of their early experiences of child care.
	After a presentation at the all-party group on children, I became interested in work based on attachment theory. Sue Gerhardt, the author of "Why Love Matters", and others have studied the impact of early parenting on babies' brains and their future mental health. Given the importance of early emotional bonding, one might conclude that nursery care would be inferior to one-to-one care at home. However, I think that work shows the importance of supporting mothers, as Sure Start does, in emotional bonding with their children. It also shows why the current framework of birth-to-three programmes and their implementation matter.
	More recently, there have been reports about what the families, children and child care study—the Penny Leach study—will conclude. Press reports suggested that young children looked after by their mothers until the age of three did significantly better in developmental tests than those cared for in nurseries or by nannies, child minders or relatives. However, Penny Leach and her team made the important statement that
	"no recommendations about childcare are made by the research team and we certainly do not advocate that all children in the early years of life must be cared for full time by their mothers, nor indeed that one form of child care is always preferable to another. However, it is the view of the team that both parental choice of care and the quality of care are most important."
	I echo those points. Parents should be able to make well-informed choices and I certainly welcome the proposals in the Bill about the expansion of local authority children's information services.
	On the choice agenda, in an ideal world—to which we should have aspirations, such as those suggested by the Daycare Trust—there would be universal, affordable, quality child care and 12 months parental leave paid at a level that would provide all parents with the option of being able to afford to stay at home to care for their children during the first years of their life if they choose to do so; a home care allowance paid to parents who choose to stay at home to look after their child aged 12 to 24 months and much more. Those are the ideals and I hope that we have those aspirations. Next week, some progress will be made with the Work and Families Bill, but there is still a long way to go. Liberal Democrat policy on child care provision at the general election was to include a maternity income guarantee, which we managed to finance only for first-time mothers. It contained a mechanism by which the money paid over the six months came up to the minimum wage. It is important that we work towards that, because people do not really have a choice with statutory maternity pay of £102 per week. I know that there is a tremendous dilemma: whether to lengthen the period of maternity and paternity leave, or to leave it as it is and increase the amount of money paid.
	When talking about child care and early years services, commentators tend to mention the experience of Sweden and Denmark. Increasingly, the recent progress of New Zealand in investing successfully in high-quality child care is also mentioned. The Nordic states have all achieved or are close to achieving two of the United Kingdom's main policy goals—near eradication of child poverty and universal early childhood services—and high levels of gender equality and women's empowerment.
	On funding levels, Sweden and Denmark currently spend around 2 to 2.5 per cent. of gross domestic product on early education and care, excluding parental leave payments. Even with the massive investment that this Government have made, which I welcome, that still accounts for just 0.43 per cent. of GDP, so we have a long way to go. The Nordic systems, to which we might aspire, have developed a truly integrated early childhood service.
	The proposals in the Bill are largely welcome, long overdue, and have the potential to offer many benefits to a lot of children and families. We must, however, keep the bigger vision in mind, despite the challenge inherent in trying to increase significantly the share of GDP spent on early years provision in future decades. Even with the current proposals, many Opposition Members are concerned about whether there will be sufficient funding to deliver the Bill's goals. Inevitably, as I comment on its specific proposals, I will have to question the cost- neutrality assumptions. I want the Bill to make a difference but, without sufficient funding, what true progress will be made in plugging some of the most important gaps?
	The requirement to place a duty on local authorities to improve the well-being of young children and to reduce inequalities between young children in their area, referring to the five well-being outcomes specified in the Children Act 2004, must be warmly welcomed in principle. I hope that we will be able to address the outcomes on looked-after children within that structure, but what will that mean in practice and how will it work effectively? On what basis will targets be set? What definitions will be used? How will monitoring take place? That requirement, in common with many in the Bill, is left to future regulations. It would be helpful if such draft regulations were made available for the Committee stage.
	A number of organisations have flagged up the concerns that were expressed by the right hon. Member for Maidenhead about partnership working between local authorities, private and voluntary providers and schools. I wonder whether the Minister will issue guidance in that respect, as there seems to be genuine concerns that existing providers may be pushed out of the market with an expansion of child care within a children's centre or on a school site. It is important that the best solution for a local area is pursued. I do not prejudge what the right or the wrong decision will be, but we need to be assured that, across the country, local authorities are consistently working in partnership.
	As we have heard, the Bill requires local authorities to secure sufficient child care to meet the needs of working parents and of those in education or training. Achieving sufficiency is defined as, first, securing child care provision that is eligible for the child care element of the working tax credit and, secondly, providing child care that is suitable for disabled children. In other words, in the Bill the duty to secure child care is closely linked to parents working.
	As other hon. Members have said, however, there will be parents who decide to stay at home with their children during the early years and they may still need to access some child care. For example, a parent may want to work part-time—I refer to the evidence that I cited earlier—or to access part-time education. I would be interested to know whether the Minister for Children and Families is considering such situations and how parents can access particular sessions of child care. There is a tension in that respect, because it is quite hard for providers to provide sessions that do not run right through the week, but such flexibility can contribute a great deal to family life.
	Having a break from child-caring responsibilities can improve parents' mental health, as we have heard. [Laughter.] The mother may be suffering from post-natal depression, which I do not think is funny. There will be other situations in which parents cannot work. I appreciate that social services may give support under the Children Act 1989, but given the constraints on social services, will that funding be sufficient? About 1.2 million children live in workless families and, like other hon. Members, I am not clear on where funding will come from when people really need support.
	I am particularly concerned about disabled children and I am worried that their families will lose out. Much is promised, but will it be delivered? Children with disabilities and their families face particular challenges, and those parents often have a need for child care beyond the need to work. For example, they may need child care to be able to spend time with their other children or to attend appointments about health and education provision for their children.
	The National Autistic Society's research shows that accessing critical services and entitlements during the early years is a key stressor impacting on the family life of a child with an autistic spectrum disorder. Securing provision of suitable child care should enhance the well-being of families in itself, regardless of work. For that reason, child care is a cost-effective intervention: providing services for children with disabilities such as ASD helps to prevent families from reaching crisis point, thus preventing reliance on costly residential placements.
	Child care provision for children with disabilities is woefully inadequate in many areas. I am very pleased that the Government are seeking to address that issue in the Bill. However, in addition to the points that I have already made, the quality and affordability of the provision required for disabled children should be considered. Will the provision of care for children with disabilities outside the main school day be included? I am also thinking of holidays and respite care.
	A mother of a severely disabled child came to my surgery the other week. Across Dorset, Bournemouth and Poole, a survey is being conducted on the provision of respite care at weekends or for whole weeks to allow the rest of the family to go away. A local authority employee told my constituent, "There is only so much money available. If we extend provision at a certain special needs school, that may well mean cuts in the overall respite budget." That was obviously very alarming for my constituent, but I have to point out that there are councils, which are starting from a relatively low base and are rather poorly funded, that may be giving with one hand and taking away with the other.
	The concept of sufficiency generally should include other difficult-to-reach groups, such as ethnic minorities, and the issue of quality as well as quantity. However, as soon as we start talking about quality issues, we come to the tensions between quality and affordability. I do not know the answer to that; I suppose that the Minister has to supply the answers. First with regard to quality, I place it firmly on the record that I do not think that it is mad or ridiculous to propose an early years foundation stage. The principle of a coherent framework that provides quality and consistency across settings is in the interests of children and practitioners. Indeed, I have heard several practitioners say that they would like the present foundation stage to be extended to seven-year-olds, as it is so firmly based on skills rather than on prescribed content.
	The details of the new proposals and their implementation are important. It is vital that children in their early years are given the freedom to learn through enjoyment, exploration and play, and allowed to investigate new skills and concepts for themselves. It is right that the hon. Member for Buckingham (John Bercow), who did not learn to speak until he was two and a half, should have been able to develop at his own pace. We need to strike a balance between teacher-orientated and child-initiated activities that are appropriate to the individual child.
	I agree with the Conservatives about clause 41. The use of the word "taught" in the clause gives me concern, when it describes
	"the matters, skills and processes which are required to be taught to young children of different abilities and maturities".
	That sets alarm bells ringing, and we must address that wording. There is also some concern that any proposal to extend the national literacy and numeracy frameworks down to the age of three will result in formalised learning at too young an age. It is vital that the chosen model should not be too prescriptive.
	The principles underlying the early years foundation stage will be very important, as were those underlying its predecessors. There are clearly differences between the principles underlying "Birth to Three Matters" and those underlying the foundation stage. For example, the former include the principle that
	"children learn best by doing rather than being told",
	while the latter includes the principle that,
	"to be effective, an early years curriculum should be carefully structured".
	It will be important to arrive at a joint set of principles across this wide developmental range, so that we get this right. Both sets of principles cover the importance of working with parents. I know that preliminary consultation is being carried out on the new proposals, and I would like to emphasise that getting the underlying principles right will form the fundamental starting point.
	In a second point on quality, research shows that who provides the early years education is vital in determining its quality and impact. The EPPE project found that, in socially diverse settings, the quality of practitioners' knowledge and understanding of the curriculum and pedagogy was vital. Some years ago, the Liberal Democrats proposed a new qualification—that of the qualified early years teacher. It would be a graduate qualification covering the three strands of early provision: health, education and social services. The long-awaited children's work force strategy was published earlier this year, and the 10-year strategy set welcome long-term goals for increasing the number of workers trained to degree level and for degree-qualified early years staff to lead all full-time day care settings.
	Given the clear evidence that positive child development depends on services being of high quality, and that a well qualified work force is the biggest determinant of quality, I am worried that only half of Britain's 100,000 nursery workers have a child care qualification. The average gross salary of a child care worker is £7,800 a year, compared with £22,662 for a graduate trained nursery or primary school teacher. The £125 million a year transformation fund announced in the 10-year strategy to support investment by local authorities in high quality, affordable, flexible and sustainable child care provision is inadequate for a radical review of the sector. Although it shows an unprecedented commitment to investing in the work force, it equates to approximately £500 per member of the work force, which is not enough to raise salaries, invest in training or increase staff numbers. Changes need to take place over time, but it is my duty to point this out today. I acknowledge that commitments are being made, but there is still such a lot to do.
	We need investment in continuous professional development. We really do need to develop a professional work force who are esteemed by the public, and in whom the public have great confidence. The tension between quality and affordability could not be greater. The Government face major challenges, given the investment that is required and the knock-on effects on the cost of child care.
	The third strand of quality is registration and inspection. We welcome the Government's commitment to retaining regulation for those who care for any children under the age of eight, but I agree with some of the organisations that have expressed concern about the regulation of crèches. Let me give another constituency example. At a major facility in Poole town centre, one of my constituents had a very unfortunate experience involving a three-year-old who was not being cared for properly. Ofsted was called in, and found that regulations were not being observed. I understand from a reply given by the Minister at the time that Ofsted wanted the facility to change and to take its recommendations on board, but it had the option of offering less than two hours' provision.
	Here is another of those famous tensions. The Government do not want to overregulate—none of us want to do that—but my constituent called on me to try to secure more regulations. What I consider important is for parents to be given information about crèches. Even a notice on the wall stating that a crèche is not subject to regulation would be helpful. Anyone would surely assume that a major facility in a town centre was regulated, and that all the staff had been checked. Could that information be added to the bank of information already available to parents?
	I also share the concerns raised about the different registers, which may prove complex in practice and difficult for parents to understand. The Bill states that the Secretary of State "may by order provide" exemptions from the requirement to register in certain circumstances. That will require a great deal of clarification in Committee.
	I have heard reports of concern about the quality and consistency of inspections of early-years facilities. I hope that as we move into a new phase, we will pay attention to the qualifications required of inspectors—the training that is required, and the processes involved in inspections. Will early-years provision at independent schools be subject to the same processes? I am pleased to learn that the same framework will apply.
	We must not underestimate the importance of self-evaluation to the process of improving quality, and to the formulation of what we hope will be rare inspections. I am sure that many Members have, like me, presented quality assurance certificates in various pre-school settings. I am always proud to do that, and am always amazed that the leaders of playgroups and nurseries have time to do all the work that is needed to earn the certificates. Such processes are very important.
	There seems to be some uncertainty—although perhaps not on the Minister's part—about the future of Investors in Children. I know that there are many different forms of quality assurance—I think that there are more than 70—but there should be a recognised kite mark which parents can understand. That was mentioned in the Government's consultation, but we do not seem to have been told what will replace Investors in Children if its funding is cut. When an inspection takes place in a school that covers early years, is an early years specialist always part of the inspection team? That would fit in with this agenda.
	I want to conclude by commenting on the new duties on and delivery by local authorities, and particularly on what is meant by "reasonably practicable", on which several Members have commented.
	We are told that the local authority must assess the market and parental needs. What are the milestones, however, to show what is reasonably practicable and what local authorities must do? There are bound to be councils in which it is very difficult to ensure that child care is available to fit every circumstance. Variations between the provision of councils such as Islington and Poole mean that their starting points will be very different. Will some families be disappointed? Is a parental guarantee being offered or simply an expectation? What is practicable in relation to children with disabilities and severe disabilities?
	It will be difficult to go out and find low-income and ethnic minority families and make them aware of and interested in all the choices. In 2002, only 3 per cent. of parents had contact with their local children's information service—that figure is from a Department for Education and Skills study. I applaud the aim of developing children's information services further, but again, councils will start from different bases, and outreach work will be required.
	Can the aspirations be delivered within existing funding? If the funding is based on the child care element of tax credits, we still have the dilemma about workless families. In that regard, we must think of what is best for the child. There is a continual dilemma relating to supply-side and demand-side funding, and the advantages and disadvantages on either side, and it would be interesting to hear about the pilot projects being carried out in London.
	In relation to the part of my constituency other than Poole, what is reasonable and practicable in very rural areas? It is important not to set up local authorities to fail, and equally important not to enable them to get away with doing the minimum. We need to know what reasonable and practicable means.
	We have had one interesting representation on listening to children, about which we all agree. It related to listening to very young children, along with parents and providers. That work has produced some interesting results, which we might explore in Committee.
	Child-centred as the Bill is, family support is so important. For families with difficulties, universal family support is needed. It is obviously very costly to provide multi-disciplinary support, work, housing, child care, literacy and training, but there are great benefits in the longer term. If the Government are serious about preventive action rather than cure, they need to examine family support much more.
	How many more parents will access child care as a result of this Bill? Without additional money, will a single child get more care, or will a single parent who is struggling with affordability no longer have to struggle? Will the Bill be a false dawn? I sincerely hope not. We will work with the Government in Committee to address our great concerns about certain aspects of the Bill, although we applaud its principles.

Ann Coffey: I welcome the Bill. The Government's continuing investment in child care and the working tax credit is and has been crucial in overcoming barriers to work and tackling inequalities. I welcome particularly the investment in Sure Start. In the poorer part of my constituency, the Sure Start project has been an outstanding success in supporting parents, raising standards of care and achieving significant improvements in language skills among the most disadvantaged children.
	I agree with my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) about the role of Sure Start in building confidence among parents. The community's commitment to the project was evident when the Minister for Children and Families opened the Sure Start building in Bridgehall recently. Huge additional value has been secured from social regeneration projects in the area, and I hope that any evaluation of the success of Sure Start projects will take that into account—they are not simply deliverers of child care.
	I look forward to the new children's centres building on the success of Sure Start in my constituency. Through a range of services, including a subsidised playgroup, it has provided support to working and non-working parents. As 4Children and other organisations have pointed out, the most disadvantaged children are in workless households and it is those children who would most benefit from high quality child care from birth, and their parents would benefit also from support. That is the basis of Sure Start provision.
	Such parents are victims of a cycle of low aspiration and poor education, handed down from generation to generation, which the Government have addressed through a number of measures. I believe that it is essential to continue to deal with inequalities from birth and that children from disadvantaged and workless families should continue to get the support offered through Sure Start, including access to good quality child care.
	Clause 6 is clear on the duty being placed on local authorities to ensure sufficient child care for parents who require it in order to take up, remain in or undertake work-related education or training. That is very important.
	Clause 7 provides a duty to secure early years provision of a prescribed description, free of charge, for such periods as may be prescribed for each young child who has attained such age as may be prescribed but is under compulsory school age. The precise nature of this measure will be known only when it is set out in the secondary legislation that is to follow, but I hope it will be explored in Committee. At present, local authorities have a responsibility under section 17 of the 1989 Act to promote the welfare of children within their area who are in need and to promote the upbringing of such children by their families. I hope that the Government intend to ensure that, under clause 7, this duty will extend to children from disadvantaged backgrounds.
	With the setting up of the new children's directorates and the Government's commitment to dealing with inequalities and improved outcomes for all children, it would certainly make sense for local authorities to look at areas of deprivation and to provide services to families that help overcome disadvantage, including good quality child care to workless households. By subsiding playgroups, the children's fund has certainly helped to show the value of such provision.
	New child care places in my constituency have been provided by the private, voluntary and public sectors. Recent legislative changes have meant that schools can be direct providers of after-school child care; indeed, it has been in their interests to do so. The spare capacity in primary schools has meant that parents are now taking into account a range of factors in making their choice of schools. Where numbers are continuing to decline, that is likely to be the case for a number of years. It also ensures that after-school clubs are more sustainable if they are registered with Ofsted and families can access the child care component of the working tax credit.
	Where schools have nursery places, private providers—there are some excellent ones in my constituency—have been providing the wrap-round child care. Some after-school activities are run on a voluntary basis. It is very much a mixture of provision, and the funds have come from various places such as the neighbourhood nursery initiative, the children's fund and Sure Start grants.
	The issue of sustainability is a real one. In one area of my constituency, a school started an after-school club, as a result of which parents who had been using a private provider ceased to do so. The private provision for two or three schools became unsustainable and the private provider withdrew the service. Some weeks later, the after-school club also folded. The net result is that there is no after-school care in the area at all. It is therefore welcome that local authorities will play a strategic role in ensuring sufficient child care, but I think that the word "sustainable" should be added to their duties—as far as is possible in a vast and changing market that depends greatly on work in the area and the demand of parents.
	I am pleased that local authorities will discharge their duties in co-operation with parents and all the providers in the area, but I make a plea that that should include parents from areas where it is often not easy to make that sort of contribution. If necessary, some training should be made available to parents to enable them to take part in the consultation.
	Many jobs in my constituency are provided by the retail sector, which, as the House knows, often works to shift patterns. Most child care in my constituency, however, is provided on an eight-to-six basis. The antisocial hours involved in shift work can raise the cost of child care, particularly for single parent families. There are also likely to be more informal care arrangements, the cost of which cannot be recovered through the working tax credit because the providers are not registered.
	I was pleased to see that parents can now pay for care in their own home and, if parents are properly consulted on the availability of child care in their area, Government initiatives such as this, which benefit shift workers and parents of disabled children, are more likely to be promoted by the local authority. At the moment, the needs of shift workers are often invisible and it is not enough to provide sufficient child care: it must be of the sort needed by parents.
	When I discussed the Bill with the carers and parents group of the Sure Start Adswood and Bridgehall project, they wanted to bring to the Minister's attention the issue of affordability. They said that that was a problem for people who worked less than full time, but more than 16 hours a week because of the operation of the benefits system. I am sure that they will welcome the Secretary of State's remarks, in which she made clear her commitment to ensuring the affordability of child care for low income families. I might add that this particular group of carers and parents took part in the consultation exercise, which again demonstrates the success of Sure Start. Some years ago, they would not have been able and would not have had the confidence to do so. That has changed because of the existence of Sure Start in the area, which should not be underestimated.
	I welcome the Bill, which demonstrates the Government's continuing commitment to investing in families and children and tackling inequalities in our society. I am sure that it will make a huge difference to my constituency.

Paul Goodman: I was concerned that my hon. Friend was about to ask me a form of question that he has been known to deploy about whether I was familiar with this clause or that clause in the Bill, which I might have overlooked. I am glad that he asked a question to which I can simply say, "Yes." I certainly hope that the Minister will provide that assurance.
	The Secretary of State's brief remarks about the role of local authorities will not quite do. She said that the Bill would place no new duties or obligations on local authorities, but she also said that a mass of money had already been provided in various forms to ensure that they could meet their duties. Those two statements do not add up. The hon. Member for Mid-Dorset and North Poole (Annette Brooke)—and, by a more roundabout route, the hon. Member for Blackpool, North and Fleetwood—pressed the Government to ensure that any duties placed on local authorities are adequately funded. That will be a pressing issue with those of us whose local authorities already have very stretched budgets and look to the years ahead with some trepidation in terms of the support they receive from the Government. It would be most unfair if local authorities, in trying to meet any obligations placed on them by the Bill, became liable for capping.
	It is important that the value of childhood is recognised in the Bill. Childhood is not simply a means to the utilitarian end of achieving academic or vocational qualifications. Childhood is part of the ordinary process of growing up and maturing as a human being. That is where much of the controversy about the Bill has lain. Attention has been drawn to an analysis of the Bill headed "Childcare Bill: Orwell in the nursery?" Miriam Stoppard claimed that the Government are headed in the wrong direction, because the Bill would introduce children to the prospect of failure at an appallingly early age and was another incursion into family life by the nanny state. The Secretary of State and other Labour Members have rubbished those fears this afternoon, but—like my hon. Friend the Member for Buckingham (John Bercow), who cited the relevant clauses earlier—I think that clause 41(2) is ambiguous. The hon. Member for Mid-Dorset and North Poole was right to concentrate on the ambiguous nature of the word "taught" in clause 41(2)(b). Clause 41(2)(a) refers to "early learning goals" and clause 41(2)(c) to "assessment arrangements". The Government will need to clarify in Committee how far they seek to push the educational process down the age range.
	It could be suggested that the Bill is pulling in two different directions. Local authorities will be obliged to provide a greater quantity of child care. The question that follows is whether the quality will match the quantity. High quality child care is not always the same as affordable child care, and the question is how the two elements are balanced. Hon. Members have been right to argue that sometimes we need to take the hit on quality to ensure that child care is affordable, but worries have been expressed about what that will mean for children with disabilities, children from minority ethnic groups and children who are at a relative disadvantage to the rest of the community. That is also a worrying aspect of the Bill and I hope that the Minister will be able to address those points when she responds to the debate tonight and that they will be further considered in Committee.

Helen Goodman: I am pleased to follow the hon. Member for Wycombe (Mr. Goodman), although I do not know whether he is my namesake or I am his. I am happy to welcome the Bill. Since 1997, the Government have made tremendous progress on early-years education and child care provision. We are all impatient for faster change, but we should remember what happened when Gladstone introduced the Education Act 1870. It took another 32 years before most children were in state-funded elementary schools. This new extension of the welfare state is just as significant as that one was, and marks a real social transformation.
	We have done well since 1997. We have an extra 500,000 places and most three and four-year-olds have taken up the guaranteed nursery places available. Even so, we need to double the number of child care places available. In particular, I welcome clause 1, which will give a new general duty to local authorities to
	"improve the well-being of young children in their area, and . . . reduce inequalities between young children in their area".
	I do not know whether that is the first time that the connection between education and poverty has been made explicit, but it is a truth that we all intuitively accept. Children who live in poverty do less well at school, and poverty of experience is an aspect of poverty. By the age of three, the children of professional families already have vocabularies that are greater than those of adults in the poorest families. We have made strides in that respect as well in the past eight years. The percentage of children who start school with cognitive delay has fallen from 40 to 26 per cent.
	Rather than repeat more statistics, I want to tell a story that a play worker described to me. She was involved in a play scheme during a half-term holiday. In the middle of the afternoon, it was time for a snack. She gave an eight-year-old an apple to eat. After the child had eaten the apple, she asked the child, "What did you think of that?" and the child said, "Well, it was very nice, but I didn't like the hard bit in the middle." The child had never eaten an apple before. It is remarkable that we can expect a child to go to school to learn that A is for apple without knowing what an apple is, and every child is entitled to that sort of straightforward experience.
	The Sure Start scheme has had a very positive impact in my constituency. We have a Sure Start programme at St. Helen Auckland with new facilities, and another on the Woodhouse Close estate, which is the most deprived part of my constituency. There are a lot of villages in Teesdale, and the rural section has mobile provision, with a fantastic bus that goes round to ensure that families who are isolated in villages also have access to services.
	The hon. Member for Mid-Dorset and North Poole (Annette Brooke) mentioned the evidence from the EPPE study. I know that it sounds like a sister of Prudence, but it stands for "effective provision of pre-school education". The study found that child care is most beneficial to those who are disadvantaged, but only if it is of high quality. That finding was further reinforced by a study by Professor Melhuish for the National Audit Office. He found that, in the first three years, high-quality child care benefited disadvantaged children and that most provision gave those who were over three educational and social benefits. So improving access to child care under the Bill, alongside the improvements in maternity pay and leave from 14 to 40 weeks, will give every child the best start.
	Clauses 39 and 44 will deliver the high-quality child care that is needed for children who live with disadvantage. Those clauses set out the early-years foundation stage that the early-years providers must meet. They also set out the process of regulation and inspection, which is important to ensure that the standards are met. Opposition Members have considered clause 41, but I draw their attention to clause 41(3), which describes the learning and development issues as follows:
	"personal, social and emotional development . . . communication, language and literacy . . . problem solving, reasoning and numeracy . . . knowledge and understanding of the world . . . physical development, and . . . creative development."
	It is not hard to argue that that broad range of experiences is what children up to the age of five and beyond need.
	Before my election to the House, I ran the National Association of Toy and Leisure Libraries, which has a 1,000 projects across the country, and I chaired the Children's Play Council. We need to take seriously the truth that small children learn through play. I am disappointed that those hon. Members who were vocal earlier this afternoon about the importance of play, rather than formal learning, are not here now, but I invite them to join the all-party parliamentary group on play which my colleagues and I want to set up.
	Ensuring that children have opportunity to play in their early years and after school and that lots of policies take account of children's need to play is essential. That has been recognised already by the Government as one of the key factors in the 10-year child care strategy, which says that activities should be
	"underpinned by a play based approach to promoting children's development and learning, building on children's experiences to help them extend their skills and develop their understanding and confidence."
	There may be doubts about the learning and development issues set out, but I ask Opposition Members how they can criticise Sure Start for not producing results, as they put it, or outcomes, if they are not prepared to agree any measure against which we can test how children perform. We would like the hon. Member for East Worthing and Shoreham (Tim Loughton) to respond to that point later this evening.
	One of the positive and significant things that has happened in the past eight years is that child care policy has been devolved to the other Administrations. So children in England, Scotland, Wales and Northern Ireland are learning in different frameworks and under different curricula. That gives us an opportunity to check how effective the English curriculum is compared with the others. For example, it will be interesting to find out whether things are better in Wales, which has a play policy.
	I remind hon. Members of what the policy framework is in Northern Ireland, because it is particularly attractive and we may want to consider it when assessing the English experience. In Northern Ireland, the early-years foundation stage is intended to
	"build self-esteem, develop the ability to play, generate an interest in stories, develop number understanding and foster curiosity."
	That is a slightly different perspective on similar themes, but some hon. Members may think it a little more child friendly.
	Although I am pleased about this extension of the welfare state—I hope that it will change society for the better—the key thing is that children are not human becomings; they are human beings. They are living now, and it is their experience now that matters. That is why the quality of provision matters as well.
	I have just three concerns about the Bill, and I hope that they will be addressed in Committee. First, why, for children over eight years, is there only provision for voluntary registration? So only risk-based inspections will be carried out, and unless someone makes a complaint, no three-yearly inspection of provision for those who are over the age of eight will take place. Although some eight and nine-year-olds are quite assertive and good at describing their needs, I am reluctant to go down the path of thinking that they should be responsible for the quality of their child care. We need to look at that a little more.
	I am unclear—perhaps the Minister can clarify this—how the Bill interrelates with the proposals on extended schools. In the move to extended schools, we need to remember that all children need time for play and that the 8 am to 6 pm provision in schools must not become purely related to homework clubs. There must be a wide range of activities, games and play time, as well as time to chill out and relax, because everyone needs that every day.
	My third concern, which has been raised by other hon. Members, relates to the qualifications that we will require. I know that the Minister intends to introduce regulations, but it would be helpful if we could see an early draft of them in Committee. The problem has been one of long standing in this country. When my mother came to England from Denmark in 1951, she was given her naturalisation certificate because she had one of the unusual skills that the economy needed—she was a nursery nurse. Here we are, 54 years down the track, and we are still short of people with such skills.
	I am not trying to suggest that solving the problem will be an easy task for the Minister. I know that the number of people who need to be recruited is in the same ball park as the numbers in the red army. It will be tremendously difficult to address the problem, but one way in which we could get a regulatory structure with a lighter touch would be by having more well qualified people working in the sector. I welcome the Bill wholeheartedly and hope that those issues can be addressed in Committee.

Robert Wilson: I do not wish to detain the House for too long because we can all agree about a awful lot in the Bill. I agree with the hon. Member for Bishop Auckland (Helen Goodman) that there has been a big improvement in early-years child care over the past decade or so.
	Most of us would agree that bringing up children is one of the most rewarding things that people can do. However, it is not always easy to juggle the many competing demands of work and home life. The Bill stems from a desire to try to help parents who often find themselves in great difficulty when juggling such responsibilities. When it comes to child care, there are sadly no easy answers or solutions for the simple reason that each family's circumstances are different. That makes it difficult for any Government to get things completely right. I acknowledge that efforts are being made and that some progress has been made over the past eight years, but I am not convinced that the Bill strikes an effective balance between the competing tensions.
	It is interesting that the 1998 general household survey found that the most popular category of child care for a mother working full or part time was that given by relatives. Having read all the various briefings on the Bill, I am left wondering how effectively it supports that option for parents. Study after study has shown that many women want to remain at home to look after their children, rather than using child minders, crèches or nurseries. Many women feel extremely guilty about returning to work only months after giving birth.
	It is also interesting to consider the matter from the perspective of what is best for the child. The effective provision of pre-school education project, which followed 3,000 children between 1997 and 2004, found that large amounts of group care before the age of three were associated with higher levels of antisocial behaviour. Such behaviour also increased if a child had received a lot of care from a child minder. However, the study found that if relatives—usually grandmothers—provided a substantial amount of care, children displayed less antisocial behaviour and were more co-operative.
	It does not take a rocket scientist to work out what is going on. Young children are much better off in the care of their mother, father or members of their close family in the early years from birth to the age of three. In fact, the Government have agreed that if mothers work full time during the early stages of their children's lives, it can have a negative impact. Families, and especially mothers, should not feel pressurised—either financially, or emotionally—to put their children's care outside their families during those important early years. I would argue that even between the ages of three to five, it is extremely beneficial if, in addition to receiving high-quality pre-school education, children have their mother or a close family member with them for part of the day.
	The Government, to their credit, recognised in the 1998 document "Meeting the Childcare Challenge" that many parents preferred grandparents or relatives to look after children. However, rather than thinking about how to support that desire of many families, the Government dismissed it as being
	"against the direction of social change"—
	the Secretary of State reinforced that belief in her opening remarks today. It was felt that only Government intervention could "fill the gaps".
	That is really what troubles me about the thrust of child care policy. It seems to be more prescriptive than necessary, and choice is talked about, rather than delivered. There appears to be a feeling that the Government know best, or at least better than families themselves. If the Government truly wished to offer choice, would they not be coming forward today with policies that offered the widest possible choice? One gets the slight feeling that the Government still believe that mothers who want to stay at home are a "bit of a problem".
	I am talking not about a bit more time for maternity leave, but about how the Government can help to support a mother through a period of years in which she brings up two or three children. The evidence shows us what is best for the child and wider society, so offering that would give families a real choice, not just a choice from a menu of state-sponsored initiatives. If the Government are really serious about one of their central principles—
	"the importance of ensuring every child has the best possible start to life"—
	they must engage in such wider thinking and reform.
	In areas in which Government intervention was needed, there has been some success. For example, Sure Start has made a contribution in some of the country's most deprived areas. Several areas have benefited significantly, so I give credit where credit is due. However, it is also true that the scheme has acted as competition with voluntary and private nurseries and play groups in those areas and has thus caused some to close.

Edward Miliband: I was going to come on to the hon. Member for Reading, East.
	It is partly a privilege to speak because this is the first child care Bill to be considered by the House, as I think the Secretary of State confirmed. It arises from the 10-year plan published a year ago at the time of the pre-Budget report of 2004. Like any legislation, it is worth asking a simple question at the outset: why is it necessary? My central case is that it is necessary because it explicitly sets out the state's responsibility for child care provision in statute for the first time. It strikes the right balance between the responsibilities of the Government, who need to plan provision at local level, and the role of voluntary and private sector providers, which other hon. Members mentioned.
	I want to argue that the Bill is, first, necessary on the grounds of equality; secondly, justified by considerations of efficiency—in particular, an analysis of the child care market and its imperfections; thirdly, necessary given the progress made since 1997 and the lessons that we have learned about child care and child care policy; and, fourthly, right in its choice of local authorities as the body responsible for planning provision and for being accountable to parents.
	So the first argument for the Bill is on grounds of equality—the need for more equal life chances for children and equal access to the labour market for women, who tend to be primary carers. Labour Members believe that although parents have the primary responsibility for children, it is, as Beveridge said 60 years ago,
	"in the national interest to help parents discharge that responsibility . . . "
	Today, we know from research that life chances are shaped not at four or five, as we used to think, but much earlier in life, with the differences apparent at 22 months. We know that the right kind of intervention—Sure Start and other policy measures—can make a difference, which is why it is right that clause 1 sets out a new duty on local authorities not just to improve children's well-being but to reduce inequalities, as my hon. Friend the Member for Bishop Auckland said.
	The case for the Bill is also based on the dramatic transformation of the role of women in the labour market. Fifty years ago, just one third of women worked; today, more than two thirds do. In the context of that change, the role for public policy is to give parents and women in particular real choice, so that they can both be at work but also have time off after the birth of a child, so that they can work part-time, and so that some can choose to work full-time and have the child care available when they need it.
	The hon. Member for Reading, East said in his interesting remarks that the Government were forcing women out to work. Perhaps I can be so bold as to suggest a bit of homework. He should look at the 10-year strategy on child care. Chart B7 on page 77 makes it clear what has happened to the position of mothers with children under five. In 1990, less than 50 per cent. of them were in work. By 2001—in just 10 years—nearly 60 per cent. were in work. The Labour Government did not force them to do that; it is mothers who want to do that.
	A large amount of bunkum—I hope that that is not unparliamentary language—has been talked about how the Government favour forcing women out to work and do nothing for mothers who want to stay at home. The pre-Budget report of 2004 allocated £600 million by 2007–08, around 40 per cent. of which went, I think, on extending paid maternity leave for mothers from six to nine months. That is nearly half the amount of money. Some of it went on the transformation fund and some on nursery education. We are helping to give mothers who want to go out to work a choice, but far from being prejudiced simply in favour of them, we are, within limited resources, helping to extend choices for mothers who want to stay at home.
	My second argument is about efficiency. For me, that is the nub of the debate—the essential reason for the Bill. It turns on whether we believe that the market on its own—Conservative Members will be interested to hear this because they are great believers in the market—can deliver the choices that we want for parents and women. In a debate in the House, Lord Lamont of Lerwick, then the right hon. Member for Kingston upon Thames and the Financial Secretary to the Treasury, summed up what was then the prevailing view of the Conservative party. He said:
	"if married women want to work and if employers want to employ them, the market will work and employers will pay the necessary wage to encourage married women to return to work."—[Official Report, 11 July 1989; Vol. 156, c. 892.]
	I welcome the Bill because the initial clauses in particular represent a profound break with that position. I believe that to be right and I want to explain why.
	On its own, the market has not delivered and will not deliver. There are three reasons for that. First, there are major gains to our society of child care and education for the under-fives which are simply not priced in the market. Economists, and I count myself as sort of an economist, would call those positive externalities. It makes the case for making child care more affordable, as the Bill will do, than it would be if it were simply left to the market.
	For parents, in particular mothers, we know the long-term costs of being out of the labour market for a number of years. Each year of interruption to hourly employment has been estimated to reduce hourly earnings by 4 per cent. The danger for our society is that if mothers are forced to stay out of the labour market, we lose their skills and talents. In the real world, the costs of child care are so high that an individual would have too low a financial gain from work in the short term without the Government playing a role. That is part of the case, which, I am sorry to say, the previous Government never accepted, for a general subsidy for lower and middle-income families—currently expressed through the child care tax credit—for the costs of child care so that the choice of whether to go out to work is real, especially for mothers with young children.
	Externalities apply not just to parents but to children. Every additional month of quality pre-school care from the age of two has been shown to improve cognitive performance at the start of school. The country has an interest in promoting integrated high-quality care and education, because that is in the long-term interests of our nation.
	There is a second market failure. Perfect markets rely on the presence of perfect information, and in child care there are significant imbalances of information. That is addressed by clauses 12 and 13. It is hard for parents truly to know the quality of their kids' child care settings. In addition, research suggests that parents facing tight cost constraints may not be fully aware of the long-term benefits of quality—hence the role for Government to ensure that the work force are properly trained and to subsidise quality. That will lead to better long-term outcomes and give parents the confidence to use child care if they wish to do so.
	The third problem with simply leaving child care to the market concerns availability. In most markets, there are low costs involved in switching from one provider to another, but clearly that is not so in child care, given the disruption faced by children and parents. I regret to say that turnover of child care providers is high. In ideal theory, there are many consumers of and providers of child care, but in many areas of our country that is not the case, so small changes in demand have very disruptive effects. There are real costs and problems in relation to sustainability, hence the need for a role for Government to try to ensure greater sustainability and continuity in the child care market. That is what clause 6, in particular, seeks to do. So the case for the Bill on the grounds of equality and efficiency is clear.

Edward Miliband: I suppose that there is a difference of opinion. I have not had the experience of being in opposition as a Member of Parliament—[Interruption]—and I do not plan to experience that for some years hence, but I would have thought that coherence was an important aim for a member of the Opposition. The problem that the hon. Gentleman highlights about the position of non-working parents is answered in part by Sure Start, which makes services available to them. If he is saying that full-time day care should be provided for non-working parents, that may be a step further down the road. I do not think that there are resources available at this point to do that. That was the only point that I was making. I hope that it was not a lacuna and that if it was, he will explain precisely why afterwards.
	I want to highlight the issue of quality, to which I referred earlier. It is a great irony that teachers of the over-5s require all kinds of qualifications—there is cross-party consensus on that—while care and education for the under-5s, who are more fragile and vulnerable, and for whom supervision is arguably even more important, have not been seen as a profession in the same way. I therefore welcome clause 13 and its new duty to provide information, advice and training to providers. That is part of the greater professionalisation of the work force envisaged in the 10-year plan which is essential to give parents the confidence of high quality, and which will work in combination with Ofsted inspection and the new transformation fund to improve quality.
	The Bill has many other positive aspects but, as I have made clear, the central and important step forward is the fact that, 60 years after Beveridge, we are making the provision of child care into a proper and legitimate duty of Government. That is more than a commitment to resources. In the 19th century, primary education for all was accepted as a responsibility of Government; in the 20th century, secondary education for all was accepted as the responsibility of Government. The Bill recognises that at the start of the 21st century we are embarking—I emphasise the word "embarking"—on a journey down a road on which pre-school provision for all will become a clear responsibility of Government. Labour Members can easily accept that, because we think that Government, working alongside the private and voluntary sector, can help to expand freedom and does not necessarily stifle individuals.
	"The welfare state contributes to people's freedom and enterprise. It is people who are secure, that dare to try their wings."
	That was said by Göran Persson, the Prime Minister of Sweden. Nowhere is it more true than in child care. That is the ethos at the heart of the Bill. I am glad that the Opposition support the Bill, but the warning to them is that if they will the ends—better child care—they had better support the means, and abandon their previous commitment to reducing public expenditure as a proportion of national income. As both leadership candidates remain committed to a smaller state we can already see contradictions emerging in their position, which we will expose over the coming months. In the meantime, I commend the Bill to the House.

Hywel Williams: It is a pleasure to follow the hon. Member for Doncaster, North (Edward Miliband), who gave a finely argued speech that will probably do no harm at all to his widely advertised prospects. He and the hon. Member for Bishop Auckland (Helen Goodman) both posited that social Darwinism had produced a certain type of education in the 19th century and another type in the 20th. At the dawn of the 21st century, everything is to the good and it all represents progress. The hon. Lady cited the Education Act 1870. The majority of the Welsh working class were literate long before then, having been taught at Griffith Jones Llanddowror circulating schools and Robert Jones Rhoslan circulating schools in the early 19th century. It is pertinent to our debate that those schools were provided without state funding and without any help from the private sector. The state was indifferent, and the private sector did not think that there was any money to be made from teaching the ignorant Welsh how to read.
	I welcome the Bill on behalf of Plaid Cymru, and I am glad that part 2 addresses issues particular to Wales. I should like mainly to address the question of rurality, which I have already raised in interventions, as well as issues relating to the Welsh language and the inequalities in child care that arise from those factors. They are largely matters for the Welsh Assembly, but they are relevant to our debate, because part 2 makes particular reference to Wales. The provision of proper child care is important, especially in rural Wales and deep rural Wales, but my argument is pertinent to child care in deep rural parts of England, and other hon. Members may wish to speak about such issues.
	Rural parts of Wales have particularly low rates of economic activity and a greater incidence of seasonal and part-time work, as well as casualised work. In some areas, a higher percentage of the work force is female, and the population receives lower wages. All those factors are relevant to consideration of the effect of child care on economic activity, on wages and prosperity, because parents with care responsibilities are much more likely to qualify for child care tax credits. The criteria for such credits are the same in both rural and urban areas, but they are more difficult to meet in rural areas, where there is a lower provision of good child care and where employer-provided child care is almost non- existent, especially in my constituency. There is therefore greater dependence on informal child care, mainly provided by relatives.
	The same regulations apply to the registration of child minders in both rural and other areas, although the circumstances are different as many relatives who provide care do not wish to be registered. Those matters are problematic in rural areas, where there is a corrosive conjunction of low wages, job insecurity, long travel distances and low child care provision, which leads to inequalities within those areas and to gross inequalities between them and urban areas. Child care in the medium of Welsh is difficult to find in both rural and urban areas. At the weekend, I was in Cardiff for the game—I was glad to see Wales beat Australia—and I had a chat with a new mother who was trying to access Welsh medium child care for her nine-week-old son in central urban Cardiff. She had been told, however, that it was now too late—she should have put his name down before the first scan. She thought that it would be easier to get him into Eton than to access good-quality registered Welsh language child care in the middle of Cardiff. Again, that may be a matter for the Welsh Assembly.
	Clauses 22 to 30 are specific to Wales. Many of those clauses replicate the English provisions, but their detailed application is left to the Welsh Assembly. There are practical reasons for doing so, as education, economic development, health and social services are devolved matters. As a member of Plaid Cymru, I cannot understand why the Welsh Assembly or even the Welsh Assembly Government cannot deal with the entire matter, as it is largely non-controversial. However, that may become the case if the Government's proposals on the Welsh Assembly Government's powers are passed. There are, however, important differences between the provisions for England and those for Wales, including the provision for child care in the medium of Welsh.
	For too long, the provision of child care has been considered part of family or education policy, or as a women's issue, rather than as a central feature of economic policy. It is such a feature in Wales because of the lower rate of economic activity and the difficulty of accessing child care to enable families to gain a decent income. The fact that it has not been considered so goes some way towards explaining the poor state of provision, which has been marginalised. Historically, low priority has been given to child care, and it compares badly with provision in other countries. The hon. Member for Bishop Auckland mentioned Scandinavia, and various Scandinavian countries immediately spring to mind.
	On the detail of part 2, clause 22, as I mentioned, makes particular reference to child care involving the use of Welsh. Clause 23 refers to less restrictive circumstances for local authorities to provide that child care themselves, so that there might be direct provision where it is very scarce. That is highly relevant, given the arguments that I have already made. Clause 26 gives the power to require local authorities to assess child care provision, but that power will lie with the Assembly, as will the terms of the required assessments. I find all those features entirely acceptable.
	The provision of child care in rural areas and through the medium of Welsh are the main themes of my remarks. I refer to some research that I commissioned in 2004, entitled "Gofal o Fath Gwahanol"—"A Different Kind of Care", which is an examination of child care in deep rural areas. If any hon. Members are interested, I have copies available. The research showed some unsurprising facts: that self-employment was very high in rural areas—50 per cent. higher in rural areas of Wales than in the rest of Wales, and that 83 per cent. of people in deep rural areas have some knowledge of the Welsh language, compared with 28 per cent. in Wales as a whole. Here we have particular features of requirements for child care, which are specific to deep rural areas.
	The research also showed that lack of child care was a problem for 40 per cent. of women in rural areas, and that was particularly the case in respect of Welsh medium child care. In those areas, part-time work was more prevalent, more people had second jobs, sub-minimum wage work was twice as prevalent, there was more dependence on cars, distances to work and to child care were greater, and there was a lower take-up of benefits. All these features conspire to make it more difficult for people with child care responsibilities—predominantly women, of course—to access child care in order to find the work that the Government are so keen for them to take up. In many ways these difficulties are structural in nature. It is impossible to shorten the distances between far-flung communities, but one can take action to ameliorate the effects of that.
	I mentioned the lower take-up of benefits. The research shows that that is partly because of a cultural perception surrounding poverty—it is not acceptable to own up to being poor—and also because of a culture of sturdy independence from the state, which is laudable. That was found not only in my research, but in the Rowntree research published on 2000.
	The research that I commissioned was largely participant observation—talking to children and to parents from a local school and a local community from Tremadog and Blaenau Ffestiniog. As I said earlier, there were tremendous problems. There was very little formal provision paid for by the private sector and very little provision from the public sector. But the pertinent point is that families did not see informal and formal care as being proxies of each other. They put them in different categories. They did not think, "Now we will use informal care, and if we have the money and the opportunity, we will use formal care," because they saw them as different things. They considered informal care by families as vastly preferable. They preferred the quality of informal care, a finding that also emerged from research by the Daycare Trust.
	People preferred to receive care from family members whom they knew, trusted and loved. The care was provided because of family ties and the love of grandparents for their grandchildren. The grandparents were not looking for registration or for a wage. They were not looking for that sort of payment, but they were looking for an acknowledgement of the cost involved. There is some cost, though it is not great.

Tim Loughton: I am delighted to be addressing such a packed House at this time of the evening. I feel that the general consensus that was breaking out at one stage has shortened this debate, which has been a good one with well-informed and weighty contributions from both sides of the House.
	We started with the Secretary of State, who I am sure has been scuppered by the time adjustment this evening, talking about the £17 billion extra that has gone into child care. She was being a little disingenuous. It would be interesting to know how that figure extrapolates, because a large part of that money is wound up in the additional funding going into Sure Start, which we have supported. We said on numerous occasions before the election that we would ring-fence that money.
	Contrary to what the hon. Member for Doncaster, North (Edward Miliband) said, we are the only party since 1997 that has held debates on children's matters in this Chamber. The Government have never held a debate on children's issues in their own time. In those debates and at questions we said that we supported Sure Start and would protect its funding, although we had ambitions to change some of its emphasis.
	It is rather disingenuous for the Secretary of State to claim that there are no new unfunded costs attached to the Bill. The Bill contains a large number of directives to local authorities to ensure the sufficient provision of child care, to carry out assessments, to facilitate training in order to bring about the big increase in staff that is needed and to provide information. All of that will have costs attached to it.
	As the hon. Member for Mid-Dorset and North Poole (Annette Brooke) rightly said, one of the big issues will be providing the child care work force required to make this Bill a reality. The transformation fund allocation of £125 million will just scratch the surface of what is required to provide training and encourage people into that line of work, as well as giving them the sustainable and decent wages that are all too often lacking now. If we do not get the staff, many of the aspirations within the Bill will not be achieved.
	The hon. Member for Blackpool, North and Fleetwood (Mrs. Humble), the chairman of the all-party childcare group, made a well informed speech, as usual. She mentioned the child care element of child tax credits and their relatively low take-up at the moment. She also emphasised the social care input that is so vital for children in early years. She raised many of the questions that many hon. Members wanted to raise in terms of some of the definitions in the Bill and what is involved in the "sufficiency" description in parts of the Bill. She also talked, rightly, as did many other hon. Members, about the problems of children with disabilities and how a relatively small number of their parents and carers are working parents and carers, with all the difficulties attached to that.
	The hon. Member for Stockport (Ann Coffey), who is in her place, made a good point; we need to see some of the regulations as soon as possible because a lot of the detail is not included in the Bill. It is vital that we have sight of at least draft regulations so that, in the discussions in Committee—as well as in another place—we can talk about the realities and the detail.
	My hon. Friend the Member for Wycombe (Mr. Goodman), who is also in his place, rightly mentioned the many stresses on parents struggling to bring up children in difficult circumstances and with financial pressures, and said that parental child care does not feature in the Bill, very important though it is. He also mentioned the word "discovery", which is useful in terms of how children develop in the early years and is different from the terminology of "taught", which features in the notorious clause 41, to which we will return on many occasions.
	My hon. Friend also mentioned the costs that will be imposed on local authorities and the potential increases in council tax that may result from that. He also talked about the need to simplify the funding streams attached to certain aspects of child care.
	The hon. Member for Bishop Auckland (Helen Goodman) said that the Bill was a real transformation and mentioned that we needed to double the number of child care places. She said that she would be setting up the all-party group of play, which is such an important element of the Bill.
	My hon. Friend the Member for Reading, East (Mr. Wilson) mentioned the importance of the family and added that this was a prescriptive Bill in many respects. To give him his due, he gave credit to Sure Start and said that his constituency had benefited from Sure Start projects. Mine has not, because we have no Sure Start project in my constituency even though I have areas of real deprivation. My hon. Friend also said that we needed a level playing field between existing and future providers and cited the issue of differential VAT treatment between private, independent providers and those working through Sure Start.
	The hon. Member for Doncaster, North, who is back in his place, spoke in dramatic terms about crossing the rubicon and about the state extending its role. I think he is right and it was very good of him to admit it up front. Some of us have concerns about the state extending its role as a parent when the state's record as a parent is a lousy one, has been for too many years and still is for those looked-after children for whom it has direct responsibility.
	The hon. Member for Doncaster, North also mentioned spending. If we analyse the costs attached to the Bill, we see that it is right that we need to spend more, but that spending must be cost-effective and well targeted. The average capital cost of a new nursery place is about £15,000. At the moment, the occupancy rate among the private and voluntary independent providers is about 76 per cent. On the face of it, there are a lot of available places, most of which are described as good quality places that could be used without the considerable capital start-up costs that will be involved in the way envisaged by the hon. Gentleman. We need to have a proper debate about whether the money is being used properly. Much of the criticism of Sure Start projects in the past was that they could not be scrutinised in isolation but must be scrutinised holistically in terms of their effect on other existing providers in those areas where they have been set up. We want to return to that.

Tim Loughton: That is a good point. If one looks at the survey that the National Day Nurseries Association has conducted among a large sample of its members, many of the vacancies are in areas where new providers, heavily subsidised at the front end, are coming in. That cannot make sense and that is why partnership and co- operation, as well as some of the conditions placed on local authorities in determining whether there is a sufficiency of supply, are vital to the Bill. We want more assurances from the Government on that.
	The hon. Member for Caernarfon (Hywel Williams) characteristically went on at length and in detail about the problems of providing child care in rural areas and, not for the first time, talked about the shortage of Welsh-medium child care. If he is on the Committee scrutinising the Bill, we may find ourselves talking about those subjects at length, as we have on previous occasions. The hon. Gentleman, in common with many other hon. Members, also talked about the extended family, and he made a good point about the need for some sort of intermediate category between formal and informal child care. There is certainly some merit in that.
	The hon. Member for Bridgend (Mrs. Moon) mentioned the problems of child care that affect us all across the country, in particular those relating to disability and the extra costs associated with that. She spoke highly of the Genesis project—a Sure Start project—in her own constituency.
	My hon. Friend the Member for Bexleyheath and Crayford (Mr. Evennett) said that the Bill represents a positive way forward. He referred to costs and factors relating to special needs that hold back many women from returning to the work force, but he rightly said that choice has to be an important part of the Bill. The one-size-fits-all model is inappropriate. He spoke about the high cost of child care places, assuming it is possible to find them, in London and also mentioned the importance of children being encouraged and enjoying their development at an early age as opposed to being formally taught. He cleverly managed to sneak in a reference to his in-laws, Peggy and Ron Smith, as we approach Christmas. I am sure that he will be relying on them for cover during the Christmas holidays—and not least for a present, too. I shall perhaps mention my in-laws later.
	The hon. Member for City of Durham (Dr. Blackman-Woods) made an interesting contribution about employment patterns, using some of the Office for National Statistics data. She was the only hon. Member to refer in detail to the need to close gaps and to tackle inequality, which is an important aspect of the Bill. She then said that we need to rely on targets to achieve that, which is where we may part company. There are many ways of reducing inequality and we believe that it should start with levelling up rather than levelling down. We will want some assurances about that when we come to debate the detail in Committee. The hon. Lady also referred to the inspection regime, which is necessary to measure quality. We can tick as many boxes as we like and increase the numbers by as many as we like, but quality is crucial. If they are not quality child care places, we are not doing any service for the children who need them and their parents. The hon. Lady also mentioned the pet Sure Start project in her constituency. It was all going so well until she lapsed into a little partisanship. To mention what happened eight and a half years is no longer sufficient; we have to go back about 34 years to refer implicitly to "Margaret Thatcher, milk snatcher"—all those years ago.
	Finally, we had a late entry from the hon. Member for Burnley (Kitty Ussher), who made a very good contribution about breaking the link between income and opportunity and raised a fair point about the need to give choices to a wider range of people. That is what the Bill should be all about.
	As I said, we have had a good debate and, to reiterate the opening comments of my right hon. Friend the Member for Maidenhead (Mrs. May), we welcome the Bill and will support it, just as we have welcomed previous child care measures. I was involved in the Children and Adoption Bill and the Children Act 2004. Indeed, we worked together across the House to improve the legislation as it went through its Committee and later stages. I hope that the same will be true of this Bill—that we have a good, well-informed and constructive debate in Committee.
	Affordable and quality child care is a subject that is at last coming of age in Westminster politics and, given the significant proportion of our constituents who are affected, that is long overdue. Ahead of the last election, it was interesting that when we produced a manifesto solely on the subject of child care, it generated considerable interest among the Government, such that the Prime Minister had to come forward at that stage and produce his own thoughts on child care. All parties recognise the importance of getting child care right. That has many implications for children, parents, child care providers and children's voluntary organisations now, but, more importantly, getting it right now will have enormous implications for the future social, educational and career development of those children as they grow up.
	It is interesting that the under-fives are the only part of the population that are projected to grow by 2012—[Interruption.]—by some 4 per cent. to 2.9 million children. It is clearly the sector of population that we should focus most on while the rest of the population shrinks—[Interruption.]—in numbers, not in size: ho, ho. I am trying to raise the level of the debate a little. As a recent report from the US National Academy of Sciences found:
	"A failure to receive care as a child can disrupt the normal development of a hormone system linked with social bonding which has significant implications for whether children develop into good and responsible citizens."
	The Bill should be subject to detailed scrutiny, and we welcome the Government's intention to allow, as I understand it, three weeks in Committee without knives, so we can properly study those proposals that require the most detailed examination. A common complaint across the House has been the lack of detail at this stage. I, for one on the Conservative Benches, have form for criticising legislation that leaves too many of the detailed considerations to secondary regulation and codes of conduct, which are all too often not produced until well after a Bill has passed all its parliamentary stages. I therefore ask the Minister whether the Government will make draft copies of their proposed regulations available during the passage of the Bill either through this House or in the other place, as that would greatly assist our deliberations.
	The general principles that we should apply to the scrutiny of the Bill are as follows. First, the measures should maximise parental choice. Whether a parent chooses to send his or her child to a state-run nursery, a voluntary-sector nursery, an independent provider, an extended family member or to leave the child at home if possible, they should not be hampered—and certainly not financially disadvantaged—in doing so. They should choose whatever course of action they believe is most suitable for their own children. As the Pre-School Learning Alliance put it:
	"Parents should be supported in whatever childcare choices they make, regardless of their personal circumstances."
	The second criterion is one of quality over quantity. It would be detrimental if, in expanding the accessibility of child care places, quality was compromised so that the development of children at crucial early years was prejudiced by inappropriate levels of care from inappropriately qualified providers. Inappropriate day care could make children more likely to suffer from emotional problems. Do the skilled work force exist or will they exist in next few years in order to provide the quality of care that we are all agreed that we need?
	Thirdly, we will judge the Bill on the degree of accessibility provided on a level playing field. There is concern that the Government intend to increase provision through working tax credits only, thereby supporting parents into work. Obviously, we need to help the most disadvantaged families—the result of poverty, disability or whatever—most of all, but many non-working families would benefit from access to additional child care help yet that funding arrangement will not apply to them. Lack of affordable child care is a problem for all parents across all social scales. In any case, the take-up of the tax credit is relatively low with only about 300,000 families currently accessing the child care element of the working tax credit. We need some answers about who else will be able to access the new child care places.
	The fourth criterion that we will apply to the Bill is simplicity and transparency. Child tax credit is notoriously complex and bureaucratic and any new arrangements for funding child care should avoid bureaucratic procedures for providers and parents—a point made in the briefing note from the National Union of Teachers.
	Fifthly, we need to achieve the right balance. What is the right child care balance between care, education and play; and what is the right balance between family care and paid professional care away from home? The Bill is centred almost entirely on the non-maternal care of young children by paid employees.
	Sixthly, another criterion that we shall apply in scrutinising the Bill is one of sustainability. It is no good creating new, heavily subsidised child care places only to knock out perfectly good-quality existing ones. As my right hon. Friend the Member for Maidenhead mentioned, for every two new places that have been created, one has been lost.
	The concern is that the advantageous models of capital cost will be paid up front, through various neighbourhood nursery schemes, for child care that is not viable in a financial sense, so that when the funding runs out after three or five years, those schemes' viability will be questionable, even though they have knocked out much of the competition. We need competition, but we need it on a level playing field that is fair to all; indeed such criticisms have been made in the past. So there are many questions that we want the Government to address this evening and during the Bill's later stages.
	Does the Minister genuinely believe that these aims can be achieved without extra funding? The Local Government Association is concerned that extra funding is simply not going to be attached to this Bill, at a time when children's services departments throughout the country are greatly stretched and undergoing significant reorganisation, largely as a result of the Children Act 2004 and the Adoption and Children Act 2002. They are rightly creating new children's services departments and directors of children's services, and new structures for child protection and for greater co-operation between, and working with, all interested parties. Can the Minister be sure that in pushing forward the measures in this Bill, those departments will not suffer from a lack of funding, and from a lack of ability to pay the attention that they must continue to pay to elements of recent legislation that they are still trying to absorb?
	According to the interdepartmental child care review, the child care work force needs to expand by some 8 per cent. every year to meet Government targets on child care growth. We need reassurance from the Minister, given the slightly disappointing child care work force strategy that was published in the spring, that the Government are on course to produce those skilled people. Turning to the difference between care and education, and the early years foundation stages innovations, the National Union of Teachers pointed out that there are no initial teacher training courses appropriate for the learning and development needs of children aged from birth to three. Concern has also been expressed about the many other responsibilities placed on local authority children's services departments, which are still absorbing and adapting to recent legislation, as I said.
	Can the Minister give us some idea of how we define the Bill's reference to reducing inequalities? Will the definition be very broad? How on earth do we define the various contributions made to society? It was difficult enough to define that in the Children Act 2004; it will surely be much more difficult to define in dealing with children between the age of birth and five. What will be the precise duty relationship between local authorities and their partners? Here, there appears to be some discrepancy with the requirements for co-operation contained in the 2004 Act. What targets are to be prescribed by the Secretary of State, and can we be assured that they will be based on quality outcomes, rather than on the ticking of quantitative boxes? How does all this relate to looked-after children? There is of course a potential conflict of interest when the local authority is facilitator and provider of early-years child care, as well as corporate parent. So we have a number of questions concerning the outcomes for looked-after children.
	On the duty to secure sufficient child care for working parents, as outlined in part 2 of the Bill, what does "sufficient" mean? What are the penalties if a local authority is deemed not to have provided sufficient child care? How does a parent complain or exercise their rights if there is insufficient means of child care in their area? Will there be an appeals process for providers if a local authority does not genuinely secure a mixed economy, or encourage proper partnership with all providers?
	Turnover of staff could also give rise to the questions of quality and continuity. What measures exist to encourage continuous improvement in quality once the initial targets have been met? How will central Government and local authorities most effectively provide guidance to parents on how to judge what factors will best benefit their children's learning that cannot come from parents themselves? How is affordability to be determined? The Bill leaves that issue hanging in the air.
	The sustainability criteria in this Bill are important. The National Day Nurseries Association has warned:
	"In many areas good quality provision is being undermined through the creation of child care for the under 5s in schools and in some newly developed Sure Start children's centres."
	Occupancy levels in many NDNA nurseries are dropping, having declined in the past year from 82 per cent. to an average of 76 per cent . . . They are in danger of becoming unsustainable. According to Laing and Buisson, an occupancy level of 90 per cent. is required to guarantee sustainability. What assessment has the Minister made of current spare capacity in the sector?
	If schools provide child care for three and four-year-olds, private and voluntary providers will be left to cater for one and two-year-olds. That is an unsustainable model, given the high staff ratios required for under-threes. It is therefore essential that Sure Start children's centre programmes build on existing child care provision, rather than duplicate it. An NDNA survey revealed the following:
	"Almost 50 per cent. of day nurseries reported that their local authority is creating a children's centre, with Government funding, nearby to their own setting. This unnecessarily duplicates existing PVI provision, the overwhelming majority of which provides services of good quality . . . The principle of a mixed economy in child care, favoured by the Government",
	is in danger of
	"being overlooked, with opportunities for local partnerships being missed. This threatens the sustainability of childcare overall".
	Other respondents to the survey said that the majority, 71 per cent.,
	"reported that local authorities were not yet involving them in the delivery of local children's centres . . . 47 per cent. of day nursery respondents confirmed that a local children's centre or school had launched childcare services aimed specifically at the under-fives, which directly competed and duplicated their own services."
	Chapter 2 of part 3 of the Bill, which deals with the requirements to be met by early-years providers, will doubtless lead to some fireworks in Committee. We have major concerns about this issue. The provision has been described as standard assessment tests for embryos. Perhaps the point is encompassed in the use of the word "taught" in clause 41(2)(b), as has been mentioned. The Daycare Trust points out the following:
	"It is important that the new Early Years Foundation Stage Framework looks at children's development in the broadest sense and does not simply educationalise services for very young children."
	The trust has also referred to this as
	"the schoolification of early years provision for very young children."
	As the Minister knows, the first two years of a child's life are crucial. The way that they develop, and are helped to develop, has a major impact on how they turn out. The wiring of the brain is a physical development— the joining together of neural pathways that takes place between birth and the age of two. At between the ages of six months and 18 months, the "social" part of the brain grows; it is not there at birth. The growth, or lack of it, depends on positive stimulus from an attentive and loving care giver. The satisfactory development of the brain almost entirely depends on the quality of attachment achieved during the first two years. That is basic attachment theory, but the point is that those first two years are very different from the following three. Yet the Bill does not differentiate between the first two years and later years. We need to pay some attention to that point.

Beverley Hughes: We have had an interesting debate, with some knowledgeable contributions from hon. Members on both sides of the House who clearly care about young children, early education and child care. I welcome the fact that Opposition Members support the Bill in principle.
	Since 1997, the Government have introduced a new and unprecedented commitment to our youngest children and their families. I can tell the hon. Member for East Worthing and Shoreham (Tim Loughton) that we have invested more than £17 billion in early years and child care; guaranteed every three and four-year-old a free nursery education place; started to integrate education with care in every setting; committed to provide a children's centre in every community; extended services in schools; introduced the working tax credit, which is likely to be worth some £800 million this year, to enable low-income families to access child care; and established more than 500,000 new child care places.
	We have done all that for two reasons. First, we know that good quality, regular pre-school provision has a markedly positive impact on young children and their subsequent development. Even after one takes into account the characteristics of the child, the family and the home, the evidence shows significant links between quality child care and better child outcomes. The research to which several hon. Members referred, including my hon. Friend the Member for Bishop Auckland (Helen Goodman), suggests that the difference in child development between having pre-school education and not having it can be of the order of four to six months. For the highest quality integrated centres, the difference can be as much as nine months. That substantial difference is achieved in only a two-year period of a child's life, which is remarkable. Good quality, integrated child care is good for young children and it helps the most disadvantaged children the most. Committed as we are to ensuring that poorer children get every chance to reach their potential and to rise beyond the circumstances of their birth, giving them the best and earliest start is essential.
	The second reason is, of course, that today's parents combine family and work—many choose to, but many have to—and need the reassurance of high-quality, reliable child care in which they can have confidence. Such child care is not only safe, but provides stimulation and the kind of developmental opportunities that every good parent provides at home.
	The Bill brings child care into the mainstream of the local services that parents can expect to be available. It ensures that parents will get the information and help that they need to gain access to those services. It gives outcomes for our youngest children the recognition and status that they deserve for the first time, and it puts statutory force behind the drive to reduce inequalities among young children. My hon. Friend the Member for Doncaster, North (Edward Miliband) was right to set the Bill in the context of the drive for equality in the interests of children, their families, our economy and, indeed, our social fabric.
	A number of important themes have been touched on by many hon. Members during the debate. The first theme is choice, which was raised by the right hon. Member for Maidenhead (Mrs. May) in her opening speech. I was somewhat perplexed to understand her contention—I paraphrase, but this is more or less it—that there is less choice under Labour and that private, voluntary and independent providers are going out of business. The facts do not stack up with that analysis.
	In 1997, 56 per cent. of three and four-year-olds were in some form of free nursery provision. The figure is 98 per cent. now. In 1997, there were just over 600,000 registered child care places; there are 1.2 million now—an increase of 95 per cent. In 1997, there was a registered place for one in eight children. There is now a registered place for one in four children. There were 6,000 day nurseries then; there are 13,000 day nurseries now. There were 3,500 out-of-school clubs in 1997; there are more than 10,000 now. Given the expansion in all kinds of provision, we can see that the choice available for people is much better now.
	A number of hon. Members expressed concern about the position of private, voluntary and independent providers. Today, 75 per cent. of full day care is provided by the private sector; only 3 per cent. is provided by local authorities. Some 63 per cent. of sessional day care—playgroups—is provided by the voluntary sector; only 4 per cent. is provided by local authorities. Far from causing a diminution in the sector's diversity, we have been increasing its diversity, and we want to continue to do so.
	None of the Opposition spokespersons picked up the point that, at least for England, the Bill says that local authorities can attempt to fulfil the sufficiency duty and fill identified gaps in child care themselves only as a last resort and when that is clearly the only acceptable thing to do. In other words, they must work with parents and providers to ensure that the gaps are filled outside the local authority sector.
	The theme of choice ran through other hon. Members' speeches. The hon. Members for Reading, East (Mr. Wilson) and for Caernarfon (Hywel Williams) seemed to suggest that, somehow, the Government extending provision and choice is tantamount to pushing parents out to work. I want to say categorically that that is not so. We believe that parents can choose whether they wish to work and, if they wish to work, what child care they want to use. It is not for the Government to regulate the use of relatives or grandparents and subject them to Ofsted inspections. I am sure that the hon. Member for Reading, East did not intend to imply that, but that is what bringing them within the Bill's scope would mean.
	Mothers and fathers are free to organise their lives and child care as they think best. I am glad that, in the end, a Conservative Member—the hon. Member for Bexleyheath and Crayford (Mr. Evennett)—mentioned fathers. Of course, we know that many fathers—albeit perhaps not Conservative Members—increasingly want to take an active part in the upbringing and care of their young children, so we want to support that. My hon. Friends the Members for Bridgend (Mrs. Moon), for City of Durham (Dr. Blackman-Woods) and for Burnley (Kitty Ussher) recognised the importance of choice to parents and the economy, and the fact that employers are increasingly recognising the business case for child care.
	The hon. Member for East Worthing and Shoreham was right to say that the issue now is not quantity, but quality. That is of paramount importance, so I share that concern with every hon. Member who raised it, including my hon. Friends the Members for Blackpool, North and Fleetwood (Mrs. Humble) and for Stockport (Ann Coffey) and the hon. Member for Mid-Dorset and North Poole (Annette Brooke), who made an intelligent and detailed speech about the importance of quality. I welcome the support of the hon. Lady and my hon. Friends for the Bill and our drive for quality.
	I can tell my hon. Friend the Member for Stockport that clause 7 provides the legal underpinning for free entitlement for all three and four-year-olds, including children in need. That is why we introduced the outcome duty, under which local authorities must pursue outcomes for children though integrated education and care. We know that such integration will drive up quality.
	That is also the drive behind the early years foundation stage and the integrated regulation and inspection framework. Much of what has been said about the foundation stage has not been helpful. It will not involve formal education and there will be no tests or rigid timetables. It will cover the sort of things that good parents do with their children—I suspect that they are things that hon. Members did automatically with their young children—so people would expect such activities to form part of a good child care setting. The foundation stage will be play-based. Children will be provided with the experiences and activities that they need to grow, learn and develop.
	We are building on existing frameworks. Although I do not want to detain the House, I recommend the "Birth to Three Matters" framework to the hon. Member for East Worthing and Shoreham—I thought for a moment he had lifted sections of it and incorporated them into his speech. Practitioners will plan for each child. They will adopt a structured approach, but the experience of the child will be spontaneous and free-flowing. Practitioners will assess children by observation and discuss progress with parents.
	Bringing together the existing "Birth to Three Matters" framework and the foundation stage will give providers a much more coherent framework to apply and follow. They are applying and following a framework now, but it is in two separate bits and it does not include the care standard. Our aim is to bring forward a coherent rationalisation of what exists at the moment.
	Quality and affordability are also important. Quality depends on a qualified, trained work force, and developing the work force can have an impact on costs. As hon. Members have rightly recognised, it is difficult for us to square that circle. We have introduced the children's work force strategy and the development council that is now helping us with it. Local authorities will have to develop their own work force strategies because different situations will exist in different areas. We will be giving £52 million a year to local authorities from next April to develop their work forces. The money will be additional to that from the transformation fund to which several hon. Members referred, through which we will try to support the development of better qualifications among the work force.
	On the demand side, the working tax credit is helping more than 330,000 families to afford child care. Of course, the free part-time education offer for all three and four-year-olds is also helping parents. The situation is complex, but with the strategy and the work force development council, and along with local authorities, we have put in place a mechanism by which we can try to ensure that we make progress. Indeed, the duty on child care is framed towards people claiming the working tax credit so that we can ensure that the child care provided is affordable.
	A number of hon. Members mentioned the role of local authorities. I was pleaded that the hon. Member for Wycombe (Mr. Goodman) recognised that they are the appropriate lead body to develop sufficient child care and to be accountable for children's outcomes in their areas. Child care has to have a local dimension. Rural areas will be different from urban areas, and it will be different for different groups of parents. That is why it is important, in terms of pursuing the flexibility to which some hon. Members referred, that local authorities take the lead.
	I do not accept that the burdens are unfunded. All the duties, in part, are already local authority duties under either the Children Acts or other regulations. Local authorities have received significant amounts in the general Sure Start grant for children's centres, extended schools and work force development. By 2007–08, they will receive £1.8 billion, which is double the figure for 2004–05. That is a substantial resource and is in addition to the £3 billion to fund the under-fives early education offer, which is going to all settings that meet the standards.
	Disabled children were mentioned. I assure hon. Members that the focus on disabled children is a result of our determination to ensure that we improve the situation for them and their families. The duty on outcomes will focus on disabled children. The child care duty highlights the needs of disabled children. The early years foundation stage will contain explicit references to children with disabilities and those with special educational needs. My hon. Friend the Member for Blackpool, North and Fleetwood was right. The findings of a recent Ofsted study show that in a majority of cases a positive attitude and a well trained team of staff make the difference between a disabled child being welcomed and included or not.
	This is a landmark Bill. It is the first Bill devoted specifically to early years and child care. It reflects our commitment to give every child the best possible start in life, with enriching experiences that will enhance their development and learning throughout their childhood and the rest of their education. It is a major public service reform, bringing integrated early years education and child care into the mainstream of a modern welfare state. It establishes once and for all that the services will be available to parents, part and parcel of the locally based family services that parents rightly expect in today's society. It is a major commitment to disadvantaged children, with a statutory duty to improve outcomes for all young children and reduce inequalities between the most disadvantaged and the rest. It puts children and parents at the heart of the legislation, and it confirms the role of local authorities as champions of those children and parents. It will give fathers and mothers genuine choices on how best to balance work and family life, and the assurance that whatever choice they make, the system is working to ensure high quality and consistency.
	I hope every hon. Member will join us in supporting these radical measures. We have the opportunity to transform permanently the shape, quality and availability of early years services for the youngest children and their parents. I hope that we can do so with consensus. I commend the Bill to the House.
	Question put and agreed to.
	Bill accordingly read a Second time.

NHS (Havering)

James Brokenshire: I am aware of services with considerable waiting times, some of which I shall highlight. Access is an issue, and if a target is not set for a particular treatment to ensure that someone is given a consultant's appointment or a diagnosis, there will be a long wait. In the London borough of Havering, it probably takes someone about a year to seek a digital hearing aid, given the demand and the available appointments. The issue has arisen in my hon. Friend's constituency, and it is a problem in Hornchurch and for my colleagues in neighbouring constituencies in Havering.
	I was highlighting the issue of the Duchess of Kent day hospital and the gap in provision. A further problem was the delay in notifying patients of the closure. I understand that some staff were not in agreement with the decision and had reservations about the closure process, and the delay in notifying patients was exacerbated by the fact that the decision was taken just before the general election, so the primary care trust was unable to go through the usual processes of the overview and scrutiny committee of the local council.
	If that is the case, the Minister might reflect on the entire process. If there is a significant change in health service provision, such as the closure of a facility, it seems odd that the calling of a general election should prevent health bodies from telling patients and local residents that that change is coming into effect. We ended up in the bizarre situation where the Duchess of Kent day hospital closed on 30 September, yet letters notifying patients of its closure went out only a week before. The report on a complaint that was made to the North East London Mental Health NHS Trust concluded that
	"it is clear that the closure process was not robustly managed and that the clients of the Duchess of Kent were probably caused some distress through the delay of information regarding the service closure and the future plans for following them up as individuals. It is right and proper therefore that an apology should be offered to the former clients of the Duchess of Kent. Assurance should also be given that lessons will be learnt from this process, that will be used in future service redesign processes."
	Because of the hiatus that I have described, some of my constituents who were mental health patients receiving support from the Duchess of Kent had to form their own self-help group. I understand that in the past few weeks one patient who was using those facilities has unfortunately been re-admitted to Mascalls Park, which is the acute facility dealing with mental health patients in the London borough of Havering. Although I could not say that that is directly connected, it suggests that if the therapies to help such patients are not in place, acute episodes may occur as a result, and people who need more significant care and attention may have to be taken into an acute hospital. That is not how we should be dealing with the care of mental health patients. We should ensure that care is available in the local community to support them, and provide the therapies that they need. I know that that is the thrust of general health policy, and I wholeheartedly endorse the provision of primary care support for mental health patients.
	It is very bad that there is a gap in service provision for patients trying to access tier 3 support. I was assured in July that patients' needs for on-going clinical care would be met
	"in a timely and appropriate manner".
	I do not see it as timely or appropriate if there is a six-month hiatus in services and people have to wait that length of time for psychological therapies that they were previously receiving at the Duchess of Kent hospital, particularly as one in four people are likely to suffer from some form of mental illness during their lifetime. Does the Minister regard the provision available to people in my constituency as an acceptable level of care?
	A further example relates to parentcraft classes for expectant mothers and fathers. As a young father with two little daughters—one of whom will celebrate her birthday tomorrow; I hope she will wake up to find daddy at home in the morning, as that would make her very pleased—I remember clearly how important the run-up to the birth of a child is in preparing for a traumatic situation, when things happen quickly. When people go into hospital, they are unsure about what is to happen and parentcraft and antenatal classes are important in helping us to understand what is likely to happen. In sharing our experiences with other expectant mums and dads, we realise that we are not alone and that there are support mechanisms to get us through a traumatic and difficult time. The Minister is nodding, so I am sure that she understands what I am talking about.
	I was thus astonished a few months ago when I received letters from constituents pointing out that antenatal classes in the community were being stopped. Parentcraft classes were no longer being supported in the NHS, which would mean that expectant mums and dads had to try to find private or non-NHS provision. The Barking, Havering and Redbridge hospitals NHS trust accepted that there was a problem, saying:
	"This is due to the increasing number of births compared to the number of midwives providing acute care and as such we do have to concentrate on the more critical areas of the service".
	In other words, the trust had to prioritise women in labour. Antenatal check-ups would not be affected; only the parentcraft classes would go. That may be all well and good in terms of service management, but I found parentcraft classes valuable and important and am disappointed, to say the least, that preparation for parents appears to be a casualty in the service.
	At the other end of the health service is the treatment of older people. My particular concern relates to services based at St. George's hospital in the centre of my constituency. The Minister may be aware of some of the concerns about the future of St. George's hospital in Hornchurch that I highlighted on my website and during my 18-month-long campaign. The facility currently has about 177 in-patient beds, mainly for the rehabilitation of older people recovering from strokes and similar ailments. In spring 2004, the PCT published an outline business case setting out various options for the future of services at St. George's hospital. Its preferred option was simply to close the whole hospital site, with one or two small exceptions, and relocate all the facilities outside my constituency, at Harold Wood in the north of the London borough of Havering, because significant changes are taking place in the property estate of the NHS, with the opening of the new Old church Park hospital in the neighbouring constituency of Romford. I note that my hon. Friend the Member for Romford (Andrew Rosindell) has joined us in the Chamber this evening. A new hospital is opening there, with the result that certain other facilities are due to be closed or reused in some way.
	The primary care trust saw that as an opportunity to review services, and to examine the care of elderly people living in the borough and how those services could be best provided. Its preferred option was to relocate those services to Harold Wood. That was due in part to the fact that around a third of the 117 beds that are currently at St. George's hospital are allocated to the Barking and Dagenham primary care trust—two thirds are allocated to the Havering primary care trust. The Barking and Dagenham primary care trust has indicated that it wishes to move its beds closer to its local community. As a consequence, 60 of the 117 beds in all likelihood are to be moved off the St. George's site. Therefore, the facilities at St. George's, and how services are to be provided from there, needed to be considered.
	The problem was that all that seemed to be happening without sufficient local consultation. When I contacted local residents to find out what they thought about the way services would be provided and what was important to them, they emphasised heavily the need to retain health care facilities on the St. George's site.
	Let us look at the demographics and the way the area is changing. The Thames gateway area is partly within the constituency itself in south Hornchurch and Rainham. There is the prospect of a lot of housing development in the southern part of the borough. It is important that we retain a significant health facility in the centre of the borough. The problem is that, if all the resources and facilities were relocated to the north of the borough, which was what the primary care trust suggested, effectively people's journey times on the transport links across the borough would increase.
	I do not see that as the most sensible way to proceed. If one is looking to provide a service that is at the centre of things, at the heart of the borough and close to where people live, St. George's is the right site to examine, particularly when we consider the fact that we are talking about elderly patients who may have relatives living nearby. We need to ensure that they are able to see their relatives and that they are given the best chance to recover and to get back into the community, which is what we all want.
	Since all this started, there have been a number of delays in deciding what the future of the services at St. George's would be. That inevitably prompted me to ask a written question to the Secretary of State for Health recently. I was somewhat disappointed that the Minister of State, Department of Health, the hon. Member for Doncaster, Central (Ms Winterton), gave me a rather anodyne reply. I asked whether the Secretary of State would make a statement on the future of St. George's hospital. The response was merely that that was
	"a matter for Havering primary care trust (PCT) as PCTs are responsible for commissioning services for the population that they serve."—[Official Report, 23 November 2005; Vol. 439, c. 2121W.]
	That is true, but it is a little disappointing that it took the Department a month to tell me that. Given that primary care trusts are effectively creatures of Government and report to strategic health authorities, which report to the Department of Health itself; given that, as I have highlighted during this debate, the Secretary of State is bringing considerable direct pressure to bear as regards primary care trusts; and given that the matter is a significant concern to constituents living in the area, I was somewhat disappointed with that response from the Department.
	Whether this was a coincidence or not, however, within the past couple of weeks, the primary care trust and the strategic health authority have issued a joint press release basically saying that the decision on the future of the hospital has been delayed for another year, so there is continuing uncertainty as to the future of that site. The Minister may think that, from my perspective, that is all well and good because no decision has been taken to close the hospital, or to transfer services from the existing hospital site. However, I remain deeply concerned about the hospital's future. In the past fortnight, I have been told that bed numbers have reduced significantly and that some wards have closed. I assume that that is part of the reorganisation, with the withdrawal by Barking and Dagenham primary care trust of some of its beds from St. George's. From the feedback that I have received from some staff, it appears that that was not communicated to them as effectively as it might have been. Anecdotal evidence suggests that morale is currently low at St. George's and that there are fears of job losses.
	There are also concerns about whether services are being scaled back even more. I said that two thirds of the 177 beds are allocated to Havering. That would reduce the number to approximately 117. However, it has been suggested that the number might decrease even further, to 90 beds. That makes the staff worried about what the future holds, especially given that the services at the day hospital appear to be reduced. That gives an impression—rightly or wrongly—that services are being scaled back slowly but surely. I am worried about that, and I would be angry if such scaling back were presented as a fait accompli and if, in six months, everybody told me, "Services have been scaled back; this isn't viable any more and we've got no choice but to close the hospital and reallocate resources"—to, for example, Harold Wood hospital, which was the PCT's preferred option.
	There is also the problem of whether the site is being redesignated outside the green belt. Again, that gives the impression to the local community of a fixed agenda to close the hospital—whether now, in six months, 12 months or two years. I ask the Minister for an assurance that she will ensure that services are not run down and that the local community will not be presented with a fait accompli. I ask for a further assurance of proper engagement with the local community and proper consultation before any final decisions are made about services that are currently provided from the St. George's site.
	I want to consider the future, especially the new Oldchurch Park hospital in Romford, which will act as the new acute hospital for the surrounding area. I greatly welcome the opening of the new, state-of-the-art facility and I look forward to that happening at the beginning of 2007. However, I am worried about whether it can cope with demand. The bed numbers at the new hospital will be less than the combination of those at the existing Oldchurch hospital and Harold Wood hospital, which the new Oldchurch Park is intended to replace. Although some additional flexibility has been built into the design so that it is possible to open a new ward if required, I emphasise that there will be fewer beds than in the two existing hospitals.
	I appreciate that the plans are based on business and healthcare models that expect additional resources in the community. It is therefore argued that so many beds will not be needed because efficiencies in theatre use, better facilities and primary care mean that there will be sufficient space, beds, resources and facilities at the new Oldchurch Park hospital. I have listened to that argument, but I remain sceptical about it. Although various local improvement finance trust—LIFT—projects are being financed in the local community to put additional primary care resources in place, I remain worried that they will not go in early enough, given that the new Oldchurch Park hospital is due to open at the beginning of 2007. I am also concerned that patients' attitudes to the NHS and to the way in which they gain access to services will not be sufficiently changed to ensure that, when the wonderful, new, sparkling hospital opens in January 2007, it will not create additional demand and people will not view it as their gateway to the health service. That is particularly the case in areas such as Rainham and south Hornchurch, where access to GP services is not the best. Sometimes it can take longer to get access to a GP there, and they are very overstretched. I know that steps are being taken to address that problem, but it will take time. Looking at the services that will be offered by the new hospital will require a different mindset; there will need to be a step change in terms of how services are accessed. I am genuinely concerned that, when the new hospital opens, it will not be able to cope with the demands that are placed on it.
	Theatre time is a key element in these arrangements, and it is extremely important that it should be used efficiently and effectively. I will continue to raise my concerns in this regard with the acute trust, to ensure that the necessary changes are implemented now, because they will need to be in place well before the new hospital opens. The new practices and approaches—the road testing, if I may use that term—must be well in place before the new hospital opens so that they are ingrained in the surgical teams, to ensure that the bookings and all the other arrangements run efficiently and effectively, and that we do not experience problems after the new Oldchurch Park hospital opens.
	I prefaced these comments by welcoming the new hospital, but I am worried that the demand and the way in which services there will be handled will create additional pressure, when people see that it is there and seek to access health care at the site. However, I welcome its opening at the beginning of 2007. I also welcome the tireless hard work that so many health care professionals provide in Havering and in my constituency of Hornchurch. They work tirelessly to ensure that my constituents and those of my hon. Friends in Romford and Upminster receive a high quality of care. However, I am worried that they are not being given the correct support, motivation or direction to ensure that they feel motivated and positive about the services that they provide. I am sure that the Minister will tell us the amount of resources that have been put into the local and national health service, but given the issues about access to health care that I have mentioned, I am worried that those resources are not getting to the front line to ensure that those issues are dealt with effectively and that all patients get the quality and standard of care that they expect and deserve.

Jane Kennedy: I am grateful for the opportunity to share this debate with the hon. Member for Hornchurch (James Brokenshire), and I congratulate him on securing it. This is clearly a matter of great concern to him and to his constituents. I am grateful to him for advertising the detail of his speech on his website; that was a great help in preparing my response. I also compliment him on the depth of knowledge that he has displayed, and on the coherent and cogent way in which he has advanced his case. I am sure that that will not have been lost on his Whips, and that they will draw it to the attention of whoever wins the Conservative leadership contest. I am sure that he has a bright future here. It particularly gives pause to a Minister to hear someone who clearly understands the nature of the challenges that the health service faces in their area.
	I give credit to the hon. Gentleman for—and join him in—paying tribute to all the staff in the local health service in Havering, whose hard work and commitment are delivering improvements to the local health service, notwithstanding the challenges that the hon. Gentleman has described. It is because we believe that local people are best placed to take decisions on the shape of local health services that we have now devolved more than 80 per cent. of the health service budget to the front line, for decisions to be taken at primary care trust level. As a direct result of that, the hon. Gentleman's local primary care trust will benefit.
	The hon. Gentleman is right. It is incumbent on me to remind the House and the public of the investment that the health service has received. His PCT will receive £303 million in 2006–07 and £331 million in 2007–08. That represents a cash increase of £52.6 million, or 18.9 per cent., over the next two years. Those resources should deliver significant benefits to the local population.
	Only last week we announced a further £2.6 million for choice and control pilot projects, of which there will be 13 in England. One will be run by the London borough of Barking and Dagenham council, and another by Essex county council. Those pilot schemes will enable older and disabled people across England to receive, as part of an innovative programme, a virtual money box, which will allow them to take control of their own social care budgets to manage their support and to choose the services that suit them best. It will help them to lead the lives that they want.
	I am particularly grateful to the hon. Gentleman for giving me the opportunity to discuss certain subjects, such as mental health services. I take a close interest in mental health, although it is not part of my portfolio. Let me deal, however, with the local issues that the hon. Gentleman raised, particularly mental health services but also podiatry services and antenatal classes for expectant mums and dads in his constituency.
	Havering PCT's planned investment in mental health services delivered by the North East London Mental Health trust has increased from £14.9 million in 2002–03 to just over £16.5 million in 2004–05. The trust now has—and is to be applauded for it—six crisis resolution teams with 55 staff, compared to the single team that it had in September 2001 with only 12 staff. It also has four assertive assertive outreach teams with 41 staff. I should add that since 1997, North East London strategic health authority has been given over 3,267 more nurses, 445 more consultants, 385 more doctors in training, 121 more GPs, 1,882 more health care assistants and 174 more qualified midwives.
	The hon. Gentleman was careful not to say that nothing was going well, although he rightly highlighted areas of concern. He mentioned the £245 million new hospital. I am sorry that I could not attend the celebration earlier in the month, but I hope to rearrange that. An extra £410,000 has been invested in primary care mental health services in the 2004–05 financial year. Much good work is being done, and a great deal of real, serious financial investment is leading to real improvements in local services.
	Before I talk about podiatry, I should deal with the hon. Gentleman's questions about the Duchess of Kent day hospital, which relate specifically to the mental health problems he described. I was interested to hear his description of the break in service that he believes some of his constituents will experience. Havering PCT decided to close the unit following the expansion of primary care-based services, which resulted in an increasingly limited range of services being offered at the day hospital. Before the closure, a formal meeting was hosted by the borough director and the therapy service manager in June 2005. Approximately 20 service users attended, so there was prior consultation. I will look into the hon. Gentleman's points about the lack of formal consultation, but care was clearly taken to ensure that service users were advised of the changes that would take place. They were given an opportunity to discuss their concerns and raise questions with clinical staff and others, who were also given the chance to discuss their concerns although they could not attend the meeting. When the unit closed, the majority of service users had completed their therapy. A very small number of service users—only six, I understand—were referred for additional therapeutic work elsewhere. I will examine all the issues that he has raised, but I wanted to reassure myself about that point.
	With regard to podiatry services, I want to reassure the hon. Gentleman that the rationale for changes to those services was based on clinical need—I accept that he does not quarrel with that—to ensure that those patients who had medical conditions that placed their lower limbs at risk, such as diabetes mellitus, peripheral vascular disease, and rheumatoid arthritis, and who were in the greatest need had access to services to improve their quality of life. I listened carefully to his representations with regard to his constituent, and he might want to write to me following the debate with the details of the case that he has in mind, and I will look into it further. He is right, however, that the PCT has sought to prioritise the way in which it uses its resources and has made those decisions. I will not offer to second-guess the decisions that the PCT has made. It is rightly charged with the responsibility of making those decisions.
	On the issue of parentcraft classes, he is right that it is a scary time for parents-to-be. The London strategic health authority cabinet has commissioned a review of maternity services across the whole of London, in direct response to the increase in births in the capital in recent years. That rise is expected to continue, which is the reverse of the national and international trend. Barking, Havering and Redbridge hospitals NHS trust maternity services, the main provider of maternity care for women living in the three boroughs, has developed initiatives to improve midwifery services. Those initiatives include the home birth support team, which has seen home births increase from 1 to 3 per cent. in the past year, and the small team of midwives focusing on the special needs of teenagers in Barking and Dagenham, which has the highest level of teenage pregnancies. I was delighted to learn that the trust won "Nurse of the Year" for that innovative service, which is in fact being driven by young mothers in the area. Midwifery-led care has been introduced for a proportion of low-risk women who are cared for solely by midwives and not consultants, who are obviously carefully selected in line with the national service framework. That is an innovative development in delivering maternity services locally. In line with the reshaping of maternity services, we expect the report from strategic health authorities in London early in the new year.
	A final new initiative was the realigning of the current skill mix for support workers in maternity services and training them to support women, both at home and in hospital, in relation to breastfeeding. Barking, Havering and Redbridge hospital is part of the Department of Health pilot for that. That does not address his specific concern about the loss of parentcraft classes, but it demonstrates the way in which the PCT has been realigning the resources that it has available in line with the priorities that it has determined locally.

Jane Kennedy: I was just about to come to that point. I am anxious to get him home so that he can get a good night's sleep in order to share his daughter's birthday, for which I wish her many happy returns.
	The decision not to continue, for the time being, with the proposed changes at St. George's hospital does not mean that the PCT will not continue to develop its strategy for older people. In fact, it means quite the opposite. I am advised by officials that the SHA and the PCT will continue to develop the strategy and refine their model of care, working in partnership with the local authority to ensure that the quality of service it provides to older people continues to improve. I will look to be kept informed on the issue.
	I have listened to and appreciated the comments made about mental health services, podiatry services and antenatal classes. I am always happy to hear hon. Members represent the views of their constituents, which helps to keep Ministers informed as to how the policies we develop in Whitehall are carried out on the ground. However, as I have mentioned, decisions about the configuration of local services now rest with the NHS locally. I am sure that the hon. Gentleman's comments will have registered with local decision makers.
	I would urge the hon. Gentleman to continue to work with his local strategic health authority and primary care trust to ensure that his views and those of his constituents are taken into consideration for any changes to services in his community.
	Question put and agreed to
	Adjourned accordingly at three minutes to Ten o'clock.

CORRECTION

22 November 2005: in col. 1380, delete Mr. Skinner's second sentence and insert "I suppose that I qualify, having had a tumour removed and a heart bypass."